Individual
JENNIFER ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
4801 VETERANS DR, SAINT CLOUD, MN 56303-2015
(320) 252-1670
Mailing address
816 15TH AVE N, SARTELL, MN 56377-1999
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP6249
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/22/2016
Last updated
12/29/2025
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