Provider Demographics
NPI:1548071343
Name:ROOT TO CROWN WELLNESS
Entity type:Organization
Organization Name:ROOT TO CROWN WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:AMINAH
Authorized Official - Middle Name:RASHIDAH
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:636-251-0751
Mailing Address - Street 1:410 HARBY DR
Mailing Address - Street 2:
Mailing Address - City:WENTZVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63385-4624
Mailing Address - Country:US
Mailing Address - Phone:636-251-0751
Mailing Address - Fax:
Practice Address - Street 1:9666 OLIVE BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63132-3013
Practice Address - Country:US
Practice Address - Phone:636-251-0751
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROOT TO CROWN WELLNESS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-01-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing