Individual
KAITLYN ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
197 PIEDMONT BLVD STE 205, ROCK HILL, SC 29732-1846
(803) 639-8066
Mailing address
810 PATRIOT PKWY APT 102, ROCK HILL, SC 29730-2767
(843) 694-9060
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-118703
SC
Other
Enumeration date
05/28/2021
Last updated
05/28/2021
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