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General NPI Number Information
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NPI Number | 1477420768
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Entity Type | Organization
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Legal Business Name | ROOT & RELEASE THERAPY, LLC
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Dates
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Enumeration Date | 10/21/2025
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 30 LOGAN ST APT 2
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City | WARWICK
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State | RI
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Zip | 02889-9507
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Country | US
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Telephone | 401-249-6033
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Fax |
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Provider Business Mailing Address
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Address Line | 30 LOGAN ST APT 2
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City | WARWICK
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State | RI
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Zip | 02889-9507
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Country | US
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Telephone | 401-249-6033
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICAL THERAPIST
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Name | MS. ETHEL-ELLA HUZDOVICH
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Credential | LMHC
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Telephone | 401-249-6033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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