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Organization

SOUTHERN ROOTS THERAPEUTIC SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MELISSA HANSFORD LPCC-S (OWNER)
(606) 304-7994
Entity
Organization

Contact information

Practice address
74 FALIN LN, WILLIAMSBURG, KY 40769-1791
(606) 304-7994
Mailing address
74 FALIN LN, WILLIAMSBURG, KY 40769-1791
(606) 304-7994

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary

Other

Enumeration date
02/08/2024
Last updated
02/08/2024
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