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Organization

HEALING ROOTS COUNSELING LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KRISTINA TUCKER MA, LPC (LICENSED PROFESSIONAL COUNSELOR)
(678) 948-5783
Entity
Organization

Contact information

Practice address
1690 STONE VILLAGE LN NW STE 601B, KENNESAW, GA 30152-7777
(678) 948-5783
Mailing address
3773 BUTTERFIELD DR NW, KENNESAW, GA 30152-6989
(678) 770-7577

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
11/30/2018
Last updated
11/30/2018
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