Doctor Name: | JENNIFER L ROTH |
NPI Number: | 1104098268 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW |
License Number: | I001005 |
Business Practice Address: | 6200 Som Center Rd Suite D-20 Solon, OH - 441392944 |
Business Phone Number: | 4402480136 |
Business Fax Number: | 4402480191 |
Mailing Address: | 6200 Som Center Rd, Suite D-20 SOLON |
State: | OH |
Postal Code: | 441392944 |
Phone Number: | 4402480136 |
Fax Number: | 4402480191 |
NPI Enumeration Date: | 03/29/2008 |
NPI Last Update Date: | 05/22/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | I001005 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |