Organization
ROOTED AND GROUNDED WELLNESS SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAILOAH WILSON CRNP-PMH (PSYCHIATRIC NURSE PRACTITIONER)
(667) 423-5544
Entity
Organization
Contact information
Practice address
100 WEST RD STE 300, TOWSON, MD 21204-2370
(667) 423-5544
Mailing address
100 WEST RD STE 300, TOWSON, MD 21204-2370
(410) 593-3299
(410) 315-1138
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/06/2024
Last updated
04/12/2024
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