Individual
SAMANTHA SARA ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
750 N FREEDOM BLVD, PROVO, UT 84601-1677
(013) 734-7608
Mailing address
750 N FREEDOM BLVD, PROVO, UT 84601-1677
(013) 734-7608
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
UT
175T00000X
Peer Specialist
—
—
Other
Enumeration date
07/17/2020
Last updated
03/28/2023
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