Individual
JUDY ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
134 STOCKTON ST APT 2B, BROOKLYN, NY 11206-5688
(347) 263-3940
Mailing address
134 STOCKTON ST APT 2B, BROOKLYN, NY 11206-5688
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
003161
NY
390200000X
Student in an Organized Health Care Education/Training Program
934942151
NY
Other
Enumeration date
05/23/2017
Last updated
02/16/2024
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