| Rooted Therapeutic Center | |
|
20312 Grazing Way Montgomery Village MD 20886-1210 | |
| (240) 644-7534 | |
| Not Available |
| Full Name | Rooted Therapeutic Center |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 20312 Grazing Way, Montgomery Village, Maryland |
| Authorized Official Name and Position | Manuela E. Mbouma (FOUNDER/THERAPIST) |
| Authorized Official Contact | 2406447534 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rooted Therapeutic Center 20312 Grazing Way Montgomery Village MD 20886-1210 Ph: () - | Rooted Therapeutic Center 20312 Grazing Way Montgomery Village MD 20886-1210 Ph: (240) 644-7534 |
| NPI Number | 1184208407 |
|---|---|
| Provider Enumeration Date | 05/12/2021 |
| Last Update Date | 05/12/2021 |
| Certification Date | 05/12/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184208407 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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