Organization
PROFESSIONAL BEHAVIORAL HEALTH MEDICINE
Active
Organization
PROFESSIONAL BEHAVIORAL HEALTH MEDICINE
Active
Other names
Professional Behavioral Health Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
TANJA N ROTH (APRN)
(785) 633-9241
Entity
Organization
Contact information
Practice address
3601 SW 29TH ST STE 112B, TOPEKA, KS 66614-2015
(785) 633-9241
(785) 670-8403
Mailing address
3601 SW 29TH ST STE 112B, TOPEKA, KS 66614-2015
(785) 633-9241
(785) 670-8403
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
5374846112
KS
Other
Enumeration date
10/14/2015
Last updated
01/22/2025
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