Organization
ROOTING WILD MOVEMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE B HARMAN LPC (OWNER/THERAPIST)
(985) 257-6774
Entity
Organization
Contact information
Practice address
4130 RIDGE AVE STE 5600, PHILADELPHIA, PA 19129-1534
(985) 257-6774
Mailing address
PO BOX 5600, PHILADELPHIA, PA 19129-0600
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/24/2024
Last updated
07/24/2024
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