Individual
MS. ELAINE ROAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISAC
Contact information
Practice address
160 NORTH MAIN STREET, BUILDING 25, TUBA CITY, AZ 86045
(928) 283-3046
(928) 283-3039
Mailing address
PO BOX 2155, TUBA CITY, AZ 86045-2155
(928) 283-3346
(928) 283-3039
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11593
AZ
Other
Enumeration date
05/15/2007
Last updated
07/08/2007
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