MEDICARE: SOARING ROOTS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1073371001
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOARING ROOTS LLC

Provider Business Mailing Address
First Line	:	680 LYNVILLE LN
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29730-9052
Country	:	US
Telephone Number	:	919-417-9008
Fax Number	:

Provider Business Practice Location Address
First Line	:	680 LYNVILLE LN
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29730-9052
Country	:	US
Telephone Number	:	919-417-9008
Fax Number	:

Authorized Official
Title or Position	:	OWNER, SPEECH-LANGUAGE PATHOLOGIST
Name	:	MORGAN ANDROZZI
Credential	:	M.S., CCC-SLP
Telephone Number	:	803-200-1619

Provider Enumeration Date	:	03/13/2024
Last Update Date	:	03/20/2024

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Directions to “SOARING ROOTS LLC ” Practice Location

Language	Start Address	Practice Location

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