Organization
NEURO-ROOTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER KALISTA LPC (OWNER)
(920) 242-0520
Entity
Organization
Contact information
Practice address
1001 S 35TH ST, MANITOWOC, WI 54220-5413
(920) 690-3955
Mailing address
1338 WESTWOOD LN, MANITOWOC, WI 54220-1602
(920) 690-3955
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
03/26/2026
Last updated
03/26/2026
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