Individual
MS. KATHRYN A ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
475 HOPE ST, PROVIDENCE, RI 02906-1639
(401) 273-2099
Mailing address
475 HOPE ST, PROVIDENCE, RI 02906-1639
(401) 273-2099
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW00647
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3437-7
BCBS PROVIDER ID #
RI
Enumeration date
03/15/2007
Last updated
08/05/2013
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