Individual
DR. SHANAN LEA ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
2201 LANEVIEW ROAD, ENNIS, TX 75119-0841
(214) 394-2502
Mailing address
2201 LANEVIEW ROAD, ENNIS, TX 75119-0841
(214) 394-2502
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
36282
TX
Other
Enumeration date
08/05/2006
Last updated
02/06/2015
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