Individual
TAMMIE ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
2200 E FRANKLIN AVE STE 200A, MINNEAPOLIS, MN 55404-2395
(651) 300-7795
Mailing address
703 WOODLAND AVE, PARK RAPIDS, MN 56470-1154
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
305286
MN
Other
Enumeration date
02/02/2023
Last updated
02/02/2023
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