Organization
RESILIENT ROOTS THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAN PAO LCSW (OWNER/LCSW)
(207) 550-1043
Entity
Organization
Contact information
Practice address
744 ROOSEVELT TRL STE 207, WINDHAM, ME 04062-5281
(207) 550-1043
Mailing address
744 ROOSEVELT TRL STE 207, WINDHAM, ME 04062-5281
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
01/10/2025
Last updated
01/10/2025
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