Organization
MENDING ROOTS HEALING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYDIA KICKLITER LCMHC (SOLE MEMBER)
(727) 643-5594
Entity
Organization
Contact information
Practice address
577 HAYWOOD RD, ASHEVILLE, NC 28806-3559
(727) 643-5594
(727) 643-5594
Mailing address
87 BOTANY DR, ASHEVILLE, NC 28805-1631
(727) 643-5594
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
06/18/2021
Last updated
06/18/2021
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