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Individual

STEPHANIE R ROTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1010 E WEST MAPLE RD, WALLED LAKE, MI 48390-3571
(248) 313-2900
Mailing address
24489 OLDE ORCHARD ST, NOVI, MI 48375-2975

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
11/14/2018
Last updated
11/14/2018
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