Individual
MRS. DIANA MARIE ROACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, CCMHC
Contact information
Practice address
4 LIBERTY ST, NEWTON, NJ 07860-1710
(862) 266-3217
Mailing address
1 COBBLE HILL RD, ANDOVER, NJ 07821-2321
(862) 266-3217
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37PC00018200
NJ
Other
Enumeration date
07/23/2010
Last updated
07/23/2010
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