Organization
ROOT TO VINE THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER DIAZ MA, ED.S., LPC (PROVIDER/OWNER)
(609) 359-3873
Entity
Organization
Contact information
Practice address
644 MANOR RD, BEVERLY, NJ 08010-1057
(215) 391-6325
Mailing address
644 MANOR RD, BEVERLY, NJ 08010-1057
(609) 359-3873
(609) 375-0666
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
08/14/2024
Last updated
07/17/2026
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