Healthcare Provider Details

I. General information

NPI: 1477151694
Provider Name (Legal Business Name): MOONSTONES AND ROSES WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2020
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23600 MERCANTILE RD STE C-100
BEACHWOOD OH
44122-5932
US

IV. Provider business mailing address

23600 MERCANTILE RD STE C-100
BEACHWOOD OH
44122-5932
US

V. Phone/Fax

Practice location:
  • Phone: 937-230-5604
  • Fax:
Mailing address:
  • Phone: 937-230-5604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. ROSE MARIE SPRUENGLI
Title or Position: SPIRITUAL LIFE COACH, DOULA
Credential: HP, SLC, WC,DOULA
Phone: 937-475-9889