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General NPI Number Information
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NPI Number | 1184424871
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Entity Type | Organization
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Legal Business Name | ROOT HAIR & WELLNESS SPA
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Dates
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Enumeration Date | 03/13/2025
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 31800 NORTHWESTERN HWY STE 120
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-1663
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Country | US
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Telephone | 248-416-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 22200 W 11 MILE RD
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City | SOUTHFIELD
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State | MI
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Zip | 48037-7136
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Country | US
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Telephone | 248-416-2200
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Fax |
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Authorized Official
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Title or Position | CERTIFIED TRICHOLOGIST, AADP
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Name | SARAH MARSHALL
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Credential |
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Telephone | 248-416-2200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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