Provider Demographics
NPI:1316742323
Name:ROOT TO BLOOM WELLNESS
Entity type:Organization
Organization Name:ROOT TO BLOOM WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD CERTIFIED PERINATAL DOULA
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:BEAUPRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-212-1688
Mailing Address - Street 1:82 ROCKY HILL RD
Mailing Address - Street 2:
Mailing Address - City:SCITUATE
Mailing Address - State:RI
Mailing Address - Zip Code:02857-1263
Mailing Address - Country:US
Mailing Address - Phone:401-212-1688
Mailing Address - Fax:
Practice Address - Street 1:82 ROCKY HILL RD
Practice Address - Street 2:
Practice Address - City:SCITUATE
Practice Address - State:RI
Practice Address - Zip Code:02857-1263
Practice Address - Country:US
Practice Address - Phone:401-212-1688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty