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Individual

JOAN ROTH

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
25 BIALYSTOKER PL, NEW YORK, NY 10002-4008
(212) 673-8500
(212) 353-9471
Mailing address
1 OLD COUNTRY RD, SUITE 271, CARLE PLACE, NY 11514-1801
(800) 725-6280
(800) 725-6380

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
015838
NY

Other

Enumeration date
05/30/2006
Last updated
07/08/2007
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