Individual
IRELAND ELIZABETH ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1880 OLD HIGHWAY 51 S STE F, BRIGHTON, TN 38011-8025
(901) 290-3916
Mailing address
90 S NORMA JEAN ST, ATOKA, TN 38004-2808
(901) 317-5479
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-246580
TN
Other
Enumeration date
07/12/2023
Last updated
07/12/2023
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