Individual
MRS. JENNIE L ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
901 HALSTEAD BLVD, ELIZABETH CITY, NC 27909-6920
(252) 338-0137
(252) 338-4512
Mailing address
1110 REID DR, ELIZABETH CITY, NC 27909-2724
(252) 338-0137
(252) 338-4512
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1704
NC
Other
Enumeration date
04/24/2008
Last updated
04/24/2008
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