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Organization
ROOTED RELATIONAL THERAPY LLC
Active
Organization
ROOTED RELATIONAL THERAPY LLC
Active
Other names
Rooted Relational Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
DOUG RICHARD MAMFT (OWNER AND THERAPIST)
(570) 884-4662
Entity
Organization
Contact information
Practice address
400 MARKET ST, MIFFLINBURG, PA 17844-1249
(570) 884-4662
Mailing address
PO BOX 54, MIFFLINBURG, PA 17844-0054
(570) 884-4662
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
NULL
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
09/09/2018
Last updated
09/18/2018
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