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General NPI Number Information
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NPI Number | 1326790437
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Entity Type | Organization
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Legal Business Name | TAPROOT FAMILY WELLNESS
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Dates
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Enumeration Date | 01/20/2022
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Last Update Date | 01/20/2022
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Provider Practice Location Address
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Address Line | 66 E MAIN ST
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City | WESTMINSTER
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State | MD
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Zip | 21157-5008
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Country | US
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Telephone | 240-602-3854
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Fax |
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Provider Business Mailing Address
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Address Line | 282 WINTERBERRY LN
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City | WESTMINSTER
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State | MD
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Zip | 21157-6642
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Country | US
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Telephone | 240-602-3854
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Fax |
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Authorized Official
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Title or Position | OWNER, THERAPIST
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Name | AMY HEIKKINEN
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Credential | LCSW-C
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Telephone | 240-602-3854
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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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