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General NPI Number Information
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NPI Number | 1295609212
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Entity Type | Organization
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Legal Business Name | NATIVE ROOTS HEALTH & WELLNESS
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Dates
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Enumeration Date | 10/02/2025
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 105 W 2ND ST # 10
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City | PEABODY
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State | KS
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Zip | 66866-1014
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Country | US
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Telephone | 316-833-2817
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 10
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City | PEABODY
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State | KS
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Zip | 66866-0010
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | GRETCHEN HIND
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Credential |
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Telephone | 316-833-2817
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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