Healthcare Provider Details

I. General information

NPI: 1730956996
Provider Name (Legal Business Name): ROOT TO RISE OCCUPATIONAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2023
Last Update Date: 12/07/2023
Certification Date: 12/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14611 BROOKVIEW DR
URBANDALE IA
50323-2642
US

IV. Provider business mailing address

21324 HIGHWAY 20 APT 101
BEND OR
97701-9851
US

V. Phone/Fax

Practice location:
  • Phone: 515-979-2068
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XM0800X
TaxonomyMental Health Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. EMILEE HUNTER-MAGUIRE
Title or Position: OCCUPATIONAL THERAPIST/OWNER
Credential: OTD
Phone: 515-979-2068