Individual
YAEL ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MFT
Contact information
Practice address
14 SWARTHMORE LN, DIX HILLS, NY 11746-4829
(631) 935-5334
Mailing address
14 SWARTHMORE LN, DIX HILLS, NY 11746-4829
(631) 935-5334
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
000100-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000100-1
NY STATE LICENSE MFT
NY
Enumeration date
12/10/2018
Last updated
12/10/2018
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