Provider Demographics
NPI:1093689937
Name:STRONG ROOTS PEDIATRIC SPEECH THERAPY WELLNESS PLLC
Entity type:Organization
Organization Name:STRONG ROOTS PEDIATRIC SPEECH THERAPY WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MACMULLEN
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:585-478-0603
Mailing Address - Street 1:888 LONG POND RD STE 4
Mailing Address - Street 2:
Mailing Address - City:GREECE
Mailing Address - State:NY
Mailing Address - Zip Code:14626-1111
Mailing Address - Country:US
Mailing Address - Phone:585-478-0603
Mailing Address - Fax:
Practice Address - Street 1:888 LONG POND RD STE 4
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-1111
Practice Address - Country:US
Practice Address - Phone:585-478-0603
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-02
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty