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Individual

NANCY E. ROTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
8 HALES HOLW, DOVER, MA 02030-2417
(508) 785-1971
Mailing address
8 HALES HOLW, DOVER, MA 02030-2417
(508) 785-1971

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
00-1020296
MA
104100000X
Social Worker

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00-1020296
DIVISION OF PROFESSIONAL LICENSURE
MA
Enumeration date
08/22/2018
Last updated
08/22/2018
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