Individual
JEANA L ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
1503 MONTGOMERY ST, URBANA, IL 61802-4742
(636) 489-4822
Mailing address
4171 CRESCENT DR STE 202, SAINT LOUIS, MO 63129-3645
(636) 489-4822
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
2018139123
MO
Other
Enumeration date
09/07/2020
Last updated
09/25/2024
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