Individual
MISS DEBRA KAY ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5350 S WESTERN AVE, 305, OKLAHOMA CITY, OK 73109-4520
(405) 632-2949
Mailing address
5350 S WESTERN AVE, 305, OKLAHOMA CITY, OK 73109-4520
(405) 632-2949
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
34005274A
IN
Other
Enumeration date
07/19/2009
Last updated
06/30/2010
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