| Doctor Name: | MS. ROXANNE SUNDERLAND |
| NPI Number: | 1932525052 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LSW |
| License Number: | S.1101603 |
| Business Practice Address: | 16 N Ohio Ave Wellston, OH - 456921230 |
| Business Phone Number: | 7403846600 |
| Business Fax Number: | |
| Mailing Address: | 16 N Ohio Ave, WELLSTON |
| State: | OH |
| Postal Code: | 456921230 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 03/13/2014 |
| NPI Last Update Date: | 03/13/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | S.1101603 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |