Individual
MRS. LEAH ELIZABETH ROTH
Active
Individual
MRS. LEAH ELIZABETH ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3955
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3927292
—
TN
01
—
4085357
BLUECROSS BLUESHIELD
TN
01
—
TN0103
JOHN DEERE
TN
Enumeration date
09/29/2005
Last updated
07/08/2007
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