Provider Demographics
NPI:1184485690
Name:STRONG ROOTS THERAPY
Entity type:Organization
Organization Name:STRONG ROOTS THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRITY
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:321-364-2085
Mailing Address - Street 1:2584 HEREFORD RD
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-2927
Mailing Address - Country:US
Mailing Address - Phone:561-452-3317
Mailing Address - Fax:
Practice Address - Street 1:2584 HEREFORD RD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-2927
Practice Address - Country:US
Practice Address - Phone:561-452-3317
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-22
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty