Individual
MRS. GRETTA M ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M. COUN., L.P.C
Contact information
Practice address
41 RENEGADE RD, RIVERTON, WY 82501-9214
(307) 709-1777
Mailing address
41 RENEGADE RD, RIVERTON, WY 82501-9214
(307) 709-1777
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1849
WY
101YP2500X
Professional Counselor
4088
ID
101YS0200X
School Counselor
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1538352828
NPI
ID
Enumeration date
11/12/2008
Last updated
07/22/2025
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