Individual
SONYA ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1301 RUSSELL RD, RUSSELLVILLE, AR 72802-4320
(479) 967-2322
Mailing address
PO BOX 2109, RUSSELLVILLE, AR 72811-2109
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
12/13/2017
Last updated
12/13/2017
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