Individual
NANCY ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1061 BLUE LAKES BLVD N, SUITE 104, TWIN FALLS, ID 83301-3362
(208) 743-0407
Mailing address
4110 HIDDEN LAKES DR, KIMBERLY, ID 83341-4000
(208) 420-0338
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-3802
ID
Other
Enumeration date
05/30/2007
Last updated
07/08/2007
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