Individual
JACLYN MARIE ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LD
Contact information
Practice address
2790 CLAY EDWARDS DR STE 600, NORTH KANSAS CITY, MO 64116-3274
(816) 691-5048
(816) 346-7039
Mailing address
2790 CLAY EDWARDS DR STE 600, NORTH KANSAS CITY, MO 64116-3274
(816) 691-5048
(816) 346-7039
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
1048325
MO
133V00000X
Registered Dietitian
Primary
2011016811
MO
Other
Enumeration date
09/14/2012
Last updated
03/10/2021
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