| Doctor Name: | MS. DEBRA ROTH |
| NPI Number: | 1003012337 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | RO45127-1 |
| Business Practice Address: | 80 University Pl 2nd Floor New York, NY - 100034564 |
| Business Phone Number: | 2123528282 |
| Business Fax Number: | |
| Mailing Address: | 115 4th Ave, Apt 5j NEW YORK |
| State: | NY |
| Postal Code: | 100034900 |
| Phone Number: | 2123528282 |
| Fax Number: | |
| NPI Enumeration Date: | 06/24/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | RO45127-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |