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General NPI Number Information
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NPI Number | 1700712270
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Entity Type | Organization
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Legal Business Name | ROOTS AND WINGS DEVELOPMENTAL STUDIO, INC.
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Dates
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Enumeration Date | 06/22/2026
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Last Update Date | 06/23/2026
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Provider Practice Location Address
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Address Line | 144 CORNELL DR
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City | DEPEW
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State | NY
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Zip | 14043-1412
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Country | US
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Telephone | 716-341-6908
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Fax |
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Provider Business Mailing Address
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Address Line | 144 CORNELL DR
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City | DEPEW
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State | NY
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Zip | 14043-1412
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Country | US
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Telephone | 716-341-6908
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. LISA CANNA
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Credential | MSED
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Telephone | 716-341-6908
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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