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General NPI Number Information
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NPI Number | 1962151456
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Entity Type | Organization
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Legal Business Name | B. ROOTED WELLNESS
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Dates
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Enumeration Date | 03/22/2022
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Last Update Date | 03/22/2023
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Provider Practice Location Address
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Address Line | 352 LEICESTER CT
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City | DETROIT
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State | MI
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Zip | 48202-1640
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Country | US
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Telephone | 313-279-7445
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Fax |
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Provider Business Mailing Address
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Address Line | 352 LEICESTER CT
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City | DETROIT
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State | MI
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Zip | 48202-1640
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Country | US
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Telephone | 313-939-0282
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Fax |
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Authorized Official
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Title or Position | OWNER/DOULA
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Name | BRIANNA EMON SIMPSON
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Credential |
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Telephone | 313-279-7445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174N00000X
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Taxonomy Name | Lactation Consultant (Non-RN)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State |
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