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Individual

MRS. FLO B ROTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW, LCSW

Contact information

Practice address
3 W FONTAINE WAY, FARMINGDALE, NJ 07727-4355
(732) 496-8030
(732) 292-1888
Mailing address
3 W FONTAINE WAY, FARMINGDALE, NJ 07727-4355
(732) 308-5505
(732) 292-1888

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SC04019
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
104295
MHN PROVIDER
NJ
01
320764
MAGELLAN PROVIDER
NJ
01
3K0788
HEALTH NET PROVIDER
NJ
01
5175525
AETNA PROVIDER
NJ
01
93662225
UBH PROVIDER
NJ
Enumeration date
10/16/2006
Last updated
11/03/2023
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