Individual
JENNIFER ISABEL ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LIMHP
Contact information
Practice address
822 N LINCOLN AVE STE A, YORK, NE 68467-2444
(402) 710-0564
(833) 382-0104
Mailing address
822 N LINCOLN AVE STE A, YORK, NE 68467-2444
(402) 710-0564
(833) 382-0104
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
10547
NE
101YM0800X
Mental Health Counselor
Primary
2203
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025173100
—
NE
Enumeration date
06/30/2015
Last updated
11/13/2020
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