Organization
HEALING ROOTS THERAPY AND CONSULTING SERVICES LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTOINETTE SHANAE NIPPER LISW-CP (OWNER)
(803) 974-9415
Entity
Organization
Contact information
Practice address
105 INDIGO PLACE CT, WEST COLUMBIA, SC 29172-2698
(803) 974-9415
Mailing address
105 INDIGO PLACE CT, WEST COLUMBIA, SC 29172-2698
(803) 974-9415
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
02/01/2022
Last updated
02/01/2022
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