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Organization
HEALING ROOTS THERAPY AND CONSULTING SERVICES LLC.
Active
Organization
HEALING ROOTS THERAPY AND CONSULTING SERVICES LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTOINETTE SHANAE NIPPER LISW-CP (OWNER)
(803) 974-9415
Entity
Organization
Contact information
Practice address
105 INDIGO PLACE CT, WEST COLUMBIA, SC 29172-2698
(803) 974-9415
Mailing address
105 INDIGO PLACE CT, WEST COLUMBIA, SC 29172-2698
(803) 974-9415
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
NULL
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
02/01/2022
Last updated
02/01/2022
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