Individual
MS. BEVERLY RAYE ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SW
Contact information
Practice address
1514 ELLIS AVENUE, LUFKIN, TX 75904
(936) 633-2772
Mailing address
1301 W. FRANK STREET, LUFKIN, TX 75904
(936) 633-2772
(936) 637-2478
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
25457
TX
Other
Enumeration date
07/24/2006
Last updated
07/08/2007
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