Individual
DR. BECKY KALVELAGE-ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
525 E NORTH ST, SUITE B, BRADLEY, IL 60915-1185
(815) 933-0667
Mailing address
211 N MEADOW ST, P.O. BOX 295, GRANT PARK, IL 60940-7077
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
03/20/2017
Last updated
03/20/2017
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