JAY ROTH

CHICAGO, IL
NPI1477900090
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: IL  149.013563)
Enumeration Date2016-05-24
Last Update Date2016-05-24
Business Address
-- JAY ROTH LCSW
200 E 115TH ST
CHICAGO, IL 60628-5015
Phone number: 312-747-2456
Mailing Address
-- JAY ROTH LCSW
200 E 115TH ST
CHICAGO, IL 60628-5015
Phone number: 312-747-2456
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