Organization
WILD ROOTS BIRTH COLLECTIVE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELYNE LIVENGOOD CD (CEO)
(573) 944-1832
Entity
Organization
Contact information
Practice address
1164A E GANNON DR, FESTUS, MO 63028-2604
(573) 944-1832
Mailing address
14268 SPRING DR, DE SOTO, MO 63020-5146
(573) 944-1832
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
—
—
Other
Enumeration date
05/16/2026
Last updated
05/16/2026
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