| Roots Therapeutic Specialty Services | |
|
10263 Chicago Dr Zeeland MI 49464-1416 | |
| (616) 377-2283 | |
| Not Available |
| Full Name | Roots Therapeutic Specialty Services |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 10263 Chicago Dr, Zeeland, Michigan |
| Authorized Official Name and Position | Diana Osipsov (OWNER/CLINICAL THERAPIST) |
| Authorized Official Contact | 6164818919 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roots Therapeutic Specialty Services 10263 Chicago Dr Zeeland MI 49464-1416 Ph: (616) 377-2283 | Roots Therapeutic Specialty Services 10263 Chicago Dr Zeeland MI 49464-1416 Ph: (616) 377-2283 |
| NPI Number | 1861023756 |
|---|---|
| Provider Enumeration Date | 01/29/2020 |
| Last Update Date | 01/29/2020 |
| Certification Date | 01/29/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861023756 | NPI | - | NPPES |
| 13582106 | Other | CAQH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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