Individual
CARLY RICHELLE ROACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
2135 BUCHANAN AVE SW, GRAND RAPIDS, MI 49507-2911
(616) 247-3638
Mailing address
100 CHERRY ST SE, GRAND RAPIDS, MI 49503-4526
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801108306
MI
Other
Enumeration date
02/20/2015
Last updated
04/15/2024
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