Individual
MADISON ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
755 S TELSHOR BLVD STE 201B, LAS CRUCES, NM 88011-3647
(505) 974-5890
Mailing address
4684 MESITA ST, LAS CRUCES, NM 88012-6329
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
X-11926
NM
Other
Enumeration date
08/11/2021
Last updated
08/11/2021
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