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Individual
THERESA A ROCHE
Active
Individual
THERESA A ROCHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW,LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2004008737
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
497324103
—
MO
Enumeration date
07/17/2006
Last updated
05/17/2015
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