Individual
DANA ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
502 W PINE ST, FARMINGTON, MO 63640-1426
(573) 218-9991
Mailing address
1000 FIANNA WAY # MD5740, FORT SMITH, AR 72919-9008
(479) 201-5740
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2014021740
MO
Other
Enumeration date
04/25/2017
Last updated
04/25/2017
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