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Organization
RESTORED ROOTS COUNSELING & WELLNESS
Active
Organization
RESTORED ROOTS COUNSELING & WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAYLA GLADIEUX LISW (OWNER/CLINICIAN)
(419) 605-8722
Entity
Organization
Contact information
Practice address
4938 STATE ROUTE 111, ANTWERP, OH 45813-9724
(419) 605-8722
Mailing address
4938 STATE ROUTE 111, ANTWERP, OH 45813-9724
(419) 605-8722
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
12/28/2020
Last updated
12/28/2020
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