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Individual

CAROL NANNETTE ROACH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
201 HIGH AVE E, OSKALOOSA, IA 52577-2838
(641) 676-3999
(866) 371-0412
Mailing address
PO BOX 1001, OSKALOOSA, IA 52577-1001
(641) 676-3999
(866) 371-0412

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
I00981
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
I00981
IOWA
IA
Enumeration date
07/31/2006
Last updated
02/19/2008
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