WILD ROOTS WELLNESS PLLC NPI 1114595600

NPI Information

NPI: 1114595600
Provider Name: WILD ROOTS WELLNESS, PLLC
Classification: Counselor - 101YP2500X
Entity Type: Organization

Specialization: Professional

Address:
4500 N 32ND ST STE 201D
PHOENIX, AZ
ZIP 85018
Phone: (480) 297-0616
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WILD ROOTS WELLNESS, PLLC is a professional counselor in Phoenix, AZ. WILD ROOTS WELLNESS, PLLC NPI is 1114595600. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4500 N 32ND ST STE 201D
PHOENIX, AZ
ZIP 85018-397
Phone: (480) 297-0616

The provider's authorized official is Monica Torres .
The authorized official title is Owner and has the following contact phone number (480) 297-0616.

The enumeration date for this NPI number is 6/11/2021 and was last updated on 6/11/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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