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Individual

SUSAN ALEXIS VON ROTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMFT

Contact information

Practice address
30 DANFORTH ST STE 311, PORTLAND, ME 04101-4574
(207) 619-3356
(207) 300-6085
Mailing address
PO BOX 8484, PORTLAND, ME 04104-8484
(207) 619-3356
(207) 300-6085

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MF7402
ME

Other

Enumeration date
02/23/2024
Last updated
02/23/2024
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