Individual
MISS LOIS L ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1070 OLD NATIONAL PIKE, FREDERICKTOWN, PA 15333-2114
(724) 632-6801
(724) 632-6312
Mailing address
1070 OLD NATIONAL PIKE, FREDERICKTOWN, PA 15333-2114
(724) 632-6801
(724) 632-6312
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007288440051
—
PA
01
—
328834A336347
VALUE BEHAVIORAL HEALTH
PA
Enumeration date
04/04/2013
Last updated
04/04/2013
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