Organization
ROOTS TO WINGS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDRIA PALMER (OWNER/THERAPIST)
(662) 889-4264
Entity
Organization
Contact information
Practice address
106 E RIDGEVILLE BLVD STE 4, MOUNT AIRY, MD 21771-5248
(662) 889-4264
Mailing address
703 PARK AVE, MOUNT AIRY, MD 21771-5423
(662) 889-4264
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
22113
MD
Other
Enumeration date
04/29/2018
Last updated
04/29/2018
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