Individual
CRYSTAL ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
102 MUHSHEE MAHCHAQ BLVD, MASHANTUCKET, CT 06338-3820
(860) 312-8023
(860) 312-8005
Mailing address
PO BOX 3260, MASHANTUCKET, CT 06338-3260
(860) 312-8023
(860) 312-8205
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149017506
IL
Other
Enumeration date
06/05/2017
Last updated
06/16/2018
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