Individual
MALAIKA ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC ADV, CPRA
Contact information
Practice address
17545 88TH AVE APT 2B, JAMAICA, NY 11432-5703
(718) 810-9218
Mailing address
17545 88TH AVE APT 2B, JAMAICA, NY 11432-5703
(718) 810-9218
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
28450
NY
101YP1600X
Pastoral Counselor
EXEMPT
NY
175T00000X
Peer Specialist
5383
NY
Other
Enumeration date
07/17/2023
Last updated
07/17/2023
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