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Organization
NOURISHED ROOTS THERAPY SERVICES
Active
Organization
NOURISHED ROOTS THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENA LEIGH SOUTHERLAND MS, CCC-SLP, CLC (SPEECH- LANGUAGE PATHOLOGIST)
(910) 310-9479
Entity
Organization
Contact information
Practice address
1271 OLD US 1 HWY UNIT B, SOUTHERN PINES, NC 28387-6308
(910) 310-9479
Mailing address
1271 OLD US 1 HWY UNIT B, SOUTHERN PINES, NC 28387-6308
(910) 310-9479
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
08/31/2023
Last updated
07/31/2025
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