Individual
KATHRYN ANN ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2450 RIVERSIDE AVE, F196, MINNEAPOLIS, MN 55454-1450
(612) 672-6000
Mailing address
10040 JOHNSON AVE S, BLOOMINGTON, MN 55437-2444
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2903
MN
Other
Enumeration date
03/20/2007
Last updated
07/08/2007
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