Organization
ROOTED THERAPY AND WELLNESS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE WISE GENDUSA LCSW, LICSW (OWNER/THERAPIST)
(509) 434-6386
Entity
Organization
Contact information
Practice address
3546 E GREYSTONE DR, FAYETTEVILLE, AR 72764-6860
(509) 434-6386
Mailing address
3546 E GREYSTONE DR, FAYETTEVILLE, AR 72764-6860
(509) 434-6386
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
10/29/2024
Last updated
10/29/2024
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