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General NPI Number Information
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NPI Number | 1215669106
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Entity Type | Organization
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Legal Business Name | INNER GROWTH THERAPY LLC
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Dates
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Enumeration Date | 06/29/2022
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Last Update Date | 06/29/2022
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Provider Practice Location Address
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Address Line | 1 CENTRE STREET TER APT 1A
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City | ROXBURY
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State | MA
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Zip | 02119-1488
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Country | US
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Telephone | 857-492-4229
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Fax |
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Provider Business Mailing Address
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Address Line | 28 CHURCH STREET SUITE 14 # 915
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City | WINCHESTER
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State | MA
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Zip | 01890-2538
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Country | US
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Telephone | 617-681-4999
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | MINELIA RODRIGUEZ-ORTIZ
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Credential | LMHC
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Telephone | 857-492-4229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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