Individual
LEAANN ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12112 CLAYTON RD, TOWN & COUNTRY, MO 63131
(314) 989-8722
Mailing address
1414 CATHY LN, FESTUS, MO 63028-4335
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2016012309
MO
Other
Enumeration date
02/13/2017
Last updated
02/13/2017
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