| NPI | 1356901284 |
|---|---|
| Former Name | MARY-ELLEN ROACH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 30603) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL 69) |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2026-04-29 |