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1003863309
MICHAEL ROACH
PINEVILLE, LA
NPI
1003863309
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: LA 5230)
Enumeration Date
2006-05-30
Last Update Date
2007-07-08
Business Address
Mr. MICHAEL ROACH LCSW
2495 SHREVEPORT HWY
PINEVILLE, LA 71360-4044
Phone number: 318-473-0010
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Mailing Address
Mr. MICHAEL ROACH LCSW
6624 LOST RIDGE DR
PINEVILLE, LA 71360-9718
Phone number: 318-466-1047
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