| NPI | 1720127293 |
|---|---|
| Former Name | STEPHANIE LOUISE ROTH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YS0200X Counselor School |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC 30942) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2007-07-08 |