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General NPI Number Information
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NPI Number | 1023652484
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Entity Type | Organization
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Legal Business Name | HEALING ROOTS THERAPY CENTER, LLC
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Dates
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Enumeration Date | 10/29/2019
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Last Update Date | 10/29/2019
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Provider Practice Location Address
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Address Line | 6218 GEORGIA AVE NW UNIT 1031
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City | WASHINGTON
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State | DC
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Zip | 20011-5125
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Country | US
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Telephone | 504-236-2982
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Fax | 833-243-7203
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Provider Business Mailing Address
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Address Line | 6218 GEORGIA AVE NW UNIT 1031
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City | WASHINGTON
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State | DC
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Zip | 20011-5125
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Country | US
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Telephone | 504-236-2982
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Fax | 833-243-7203
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Authorized Official
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Title or Position | OWNER / PROVIDER
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Name | AALIYAH MUHAMMAD
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Credential |
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Telephone | 504-236-2982
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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