Individual
JEANETTE MARIE ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCC-SLP
Contact information
Practice address
3901 WRIGHTSVILLE AVE STE 120, WILMINGTON, NC 28403-6256
(910) 679-8385
(910) 679-8385
Mailing address
1004 PRIMIVERA CT, WILMINGTON, NC 28409-4869
(908) 415-0895
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12318
NC
235Z00000X
Speech-Language Pathologist
41YS00494500
NJ
Other
Enumeration date
08/02/2017
Last updated
01/16/2020
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