Individual
HASHIM R ROACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1115 W CHESTNUT ST STE 101, BROCKTON, MA 02301-7501
(508) 521-2287
Mailing address
21 HIGHLAND TER, BROCKTON, MA 02301-3208
(617) 797-4057
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/03/2016
Last updated
07/21/2022
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