Individual
MS. ADRIENNE THERESE ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PCC/LCDC
Contact information
Practice address
624 MARKET AVE. N., CANTON, OH 44702-1017
(330) 493-4553
(330) 493-3761
Mailing address
624 MARKET AVE. N, CANTON, OH 44702-1017
(330) 493-4553
(330) 493-3761
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
702977
OH
101YM0800X
Mental Health Counselor
Primary
E.1100044
OH
Other
Enumeration date
08/30/2012
Last updated
10/05/2021
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