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1326114992
ELLEN ROTH
NEW CITY, NY
NPI
1326114992
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NY R0361531)
Enumeration Date
2006-11-27
Last Update Date
2007-07-08
Business Address
-- ELLEN ROTH LCSW R
20 SQUADRON BOULEVARD #560 DR MARK TARLE
NEW CITY, NY 10956
Phone number: 845-639-3150
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Mailing Address
-- ELLEN ROTH LCSW R
62 GEDNEY STREET
NYACK, NY 10960-2208
Phone number: 845-358-0044
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