Individual
STEPHANIE ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11858 N 900 W, MONTICELLO, IN 47960-7801
(574) 581-1717
Mailing address
11858 N 900 W, MONTICELLO, IN 47960-7801
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31005619A
IN
Other
Enumeration date
01/19/2015
Last updated
01/19/2015
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