Individual
AMY ELISE ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
308 RACEBROOK ROAD, ORANGE, CT 06477
(203) 920-1885
Mailing address
615 CENTRAL AVE APT 3, NEW HAVEN, CT 06515-2124
(203) 314-5349
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
005650
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/15/2017
Last updated
10/22/2020
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