Individual
RICHARD TAYLOR ROE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
3000 OLD CANTON RD STE 470, JACKSON, MS 39216-4225
(346) 206-1650
Mailing address
3409 OLD CANTON RD, JACKSON, MS 39216-3236
(346) 206-1650
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
66162
TX
1041C0700X
Clinical Social Worker
Primary
C9989
MS
1041C0700X
Clinical Social Worker
TPSW2507
FL
Other
Enumeration date
06/11/2019
Last updated
01/23/2024
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