Individual
DR. KATTRINA ROACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
8829 CENTRE ST, SOUTHAVEN, MS 38671-2610
(662) 280-5758
(662) 280-5708
Mailing address
1622 MONTYS CIR, SOUTHAVEN, MS 38672-8547
(662) 404-1134
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
2041
MS
101YM0800X
Mental Health Counselor
2041
MS
101YP2500X
Professional Counselor
Primary
2041
MS
Other
Enumeration date
12/11/2015
Last updated
12/11/2015
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