Individual
MR. MICHAEL ROACH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2495 SHREVEPORT HWY, PINEVILLE, LA 71360-4044
(318) 473-0010
Mailing address
6624 LOST RIDGE DR, PINEVILLE, LA 71360-9718
(318) 466-1047
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5230
LA
Other
Enumeration date
05/30/2006
Last updated
07/08/2007
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