| Restored Roots Counseling & Wellness | |
|
4938 State Route 111 Antwerp OH 45813-9724 | |
| (419) 605-8722 | |
| Not Available |
| Full Name | Restored Roots Counseling & Wellness |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 4938 State Route 111, Antwerp, Ohio |
| Authorized Official Name and Position | Kayla Gladieux (OWNER/CLINICIAN) |
| Authorized Official Contact | 4196058722 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Restored Roots Counseling & Wellness 4938 State Route 111 Antwerp OH 45813-9724 Ph: (419) 605-8722 | Restored Roots Counseling & Wellness 4938 State Route 111 Antwerp OH 45813-9724 Ph: (419) 605-8722 |
| NPI Number | 1922695758 |
|---|---|
| Provider Enumeration Date | 12/28/2020 |
| Last Update Date | 12/28/2020 |
| Certification Date | 12/28/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922695758 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Secondary |