Provider Demographics
NPI:1184424871
Name:ROOT HAIR & WELLNESS SPA
Entity type:Organization
Organization Name:ROOT HAIR & WELLNESS SPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED TRICHOLOGIST, AADP
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-416-2200
Mailing Address - Street 1:22200 W 11 MILE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48037-7136
Mailing Address - Country:US
Mailing Address - Phone:248-416-2200
Mailing Address - Fax:
Practice Address - Street 1:31800 NORTHWESTERN HWY STE 120
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-1663
Practice Address - Country:US
Practice Address - Phone:248-416-2200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty