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Individual
MS. GLENDA GAYLE ROACH
Active
Individual
MS. GLENDA GAYLE ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW, T-LAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LMSW 9424
KS
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-LAC 1191
KS
Other
Enumeration date
12/09/2014
Last updated
12/09/2014
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