| Roots & Wings Therapy Llc | |
|
115 E 1st St Ste 120 Dixon IL 61021-3023 | |
| (773) 930-0994 | |
| Not Available |
| Full Name | Roots & Wings Therapy Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 115 E 1st St Ste 120, Dixon, Illinois |
| Authorized Official Name and Position | Stacy Jo Barber (OWNER) |
| Authorized Official Contact | 7739300994 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roots & Wings Therapy Llc 115 E 1st St Ste 120 Dixon IL 61021-3023 Ph: (773) 930-0994 | Roots & Wings Therapy Llc 115 E 1st St Ste 120 Dixon IL 61021-3023 Ph: (773) 930-0994 |
| NPI Number | 1073160537 |
|---|---|
| Provider Enumeration Date | 08/20/2019 |
| Last Update Date | 08/20/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073160537 | NPI | - | NPPES |
| 1073963963 | Other | IL | NPI |
| 1992201479 | Other | IL | NPI |
| 1336792514 | Other | IL | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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