| NPI | 1467639476 |
|---|---|
| Former Name | STEPHANIE L ROTH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 078270) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 074884-1) |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2016-08-27 |