Individual
ELIZABETH ANN ROETHKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
380 ASHBURY CIR, DALLAS, GA 30157-1443
(610) 861-0797
Mailing address
380 ASHBURY CIR, DALLAS, GA 30157-1443
(610) 861-0797
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
PS006298L
PA
Other
Enumeration date
04/10/2006
Last updated
03/13/2026
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