Individual
ELISA ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
1225 S GEAR AVE, WEST BURLINGTON, IA 52655-1691
(319) 850-3443
Mailing address
1225 S GEAR AVE, WEST BURLINGTON, IA 52655-1691
(319) 850-3443
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1691
IA
Other
Enumeration date
04/10/2015
Last updated
03/29/2021
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