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1235842907
JEANNA MARIE ROTH
NEW BRIGHTON, MN
NPI
1235842907
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MN 303934)
Enumeration Date
2022-12-27
Last Update Date
2022-12-27
Business Address
JEANNA MARIE ROTH LADC
1900 SILVER LAKE RD NW STE 110
NEW BRIGHTON, MN 55112-1789
Phone number: 651-628-9566
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Mailing Address
JEANNA MARIE ROTH LADC
16427 BEAVER DR
BIG LAKE, MN 55309-4859
Phone number: 612-834-2318
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