Individual
JENNIFER ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1333 IRIS AVE, BOULDER, CO 80304-2226
(303) 443-8500
Mailing address
1333 IRIS AVE, BOULDER, CO 80304-2226
(303) 443-8500
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
225X00000X
Occupational Therapist
Primary
OT22592
FL
Other
Enumeration date
12/24/2013
Last updated
12/07/2022
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