Individual
BRYE ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC-S
Contact information
Practice address
1414 RIVERSIDE DR STE 200, LAKEWOOD, OH 44107-3319
(440) 508-6765
Mailing address
1527 WINTON AVE, LAKEWOOD, OH 44107-3613
(440) 454-3243
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
E.2202815
OH
101YP2500X
Professional Counselor
Primary
E.2202815-SUPV
OH
Other
Enumeration date
07/29/2019
Last updated
05/01/2023
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