Individual
PATRICIA NICOLE ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
100 LAKE TRAVERSE DR, SISSETON, SD 57262-7046
(605) 698-7606
(605) 742-3888
Mailing address
100 LAKE TRAVERSE DR, SISSETON, SD 57262-7046
(605) 698-7606
(605) 742-3888
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15061692
SD
Other
Enumeration date
06/03/2020
Last updated
06/03/2020
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