Organization
ROOTED THERAPEUTIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MANUELA E. MBOUMA LCPC (FOUNDER/THERAPIST)
(240) 644-7534
Entity
Organization
Contact information
Practice address
20312 GRAZING WAY, MONTGOMERY VILLAGE, MD 20886-1210
(240) 644-7534
Mailing address
20312 GRAZING WAY, MONTGOMERY VILLAGE, MD 20886-1210
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/12/2021
Last updated
05/12/2021
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