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1770191553
SAMANTHA SARA ROTH
PROVO, UT
NPI
1770191553
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
175T00000X Peer Specialist
Enumeration Date
2020-07-17
Last Update Date
2023-03-28
Business Address
SAMANTHA SARA ROTH
750 N FREEDOM BLVD
PROVO, UT 84601-1677
Phone number: 013-734-7608
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Mailing Address
SAMANTHA SARA ROTH
750 N FREEDOM BLVD
PROVO, UT 84601-1677
Phone number: 013-734-7608
Copy
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