Doctor Name: | KRISTA MICHELLE ROACH |
NPI Number: | 1588739049 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.P.C. |
License Number: | 2349 |
Business Practice Address: | 13347 S 21st St Bixby, OK - 740081070 |
Business Phone Number: | 9189356493 |
Business Fax Number: | 9189436078 |
Mailing Address: | 13347 S 21st St, BIXBY |
State: | OK |
Postal Code: | 740081070 |
Phone Number: | 9189356493 |
Fax Number: | 9189436078 |
NPI Enumeration Date: | 11/21/2006 |
NPI Last Update Date: | 09/13/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 2349 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |