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Individual

MRS. AMBER LOU ROARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW,LCAC

Contact information

Practice address
8520 ALLISON POINTE BLVD, SUITE 220, INDIANAPOLIS, IN 46250
(855) 478-4357
Mailing address
1467 SISKIYOU BLVD STE 2027, ASHLAND, OR 97520-2336
(855) 478-4357

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
87000663A
IN
104100000X
Social Worker
33006295A
IN
1041C0700X
Clinical Social Worker
Primary
34008575A
IN

Other

Enumeration date
11/06/2014
Last updated
01/18/2022
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