Individual
CLINTON SAMUEL ROLLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
32 MILLBRANCH RD STE 40, HATTIESBURG, MS 39402-1673
(601) 255-5265
Mailing address
2885 W BATTLEFIELD ST, SPRINGFIELD, MO 65807-3952
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/26/2023
Last updated
08/16/2024
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