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General NPI Number Information
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NPI Number | 1548071343
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Entity Type | Organization
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Legal Business Name | ROOT TO CROWN WELLNESS
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Dates
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Enumeration Date | 01/20/2025
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | 9666 OLIVE BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63132-3013
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Country | US
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Telephone | 636-251-0751
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Fax |
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Provider Business Mailing Address
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Address Line | 410 HARBY DR
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City | WENTZVILLE
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State | MO
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Zip | 63385-4624
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Country | US
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Telephone | 636-251-0751
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | AMINAH RASHIDAH WILLIAMS
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Credential | LPC
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Telephone | 636-251-0751
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QB0400X
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Taxonomy Name | Birthing Clinic/Center
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License Number |
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License Number State |
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