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Organization
HOME ROOTED THERAPY LLC
Active
Organization
HOME ROOTED THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA FISKE (AUTHORIZED OFFICIAL)
(989) 573-5046
Entity
Organization
Contact information
Practice address
122 UPTOWN DR # 204-11, BAY CITY, MI 48708-5617
(989) 573-5043
Mailing address
1329 GLENDALE AVE, SAGINAW, MI 48638-4723
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
04/01/2024
Last updated
04/01/2024
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