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Organization
ROOTS & WINGS THERAPY LLC
Active
Organization
ROOTS & WINGS THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY JO BARBER LCPC & ART THERAPIST (OWNER)
(773) 930-0994
Entity
Organization
Contact information
Practice address
115 E 1ST ST STE 120, DIXON, IL 61021-3023
(773) 930-0994
Mailing address
115 E 1ST ST STE 120, DIXON, IL 61021-3023
(773) 930-0994
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073963963
NPI
IL
01
—
1336792514
NPI
IL
01
—
1992201479
NPI
IL
Enumeration date
08/20/2019
Last updated
08/20/2019
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