Individual
KYLIE ANN ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4945 SQUIRREL ST, SPRINGFIELD, OR 97478-7767
(719) 337-8376
Mailing address
4945 SQUIRREL ST, SPRINGFIELD, OR 97478-7767
(719) 337-8376
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
08/14/2026
Last updated
08/14/2026
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