Organization
JULIE ROTH, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE ROTH LCPC (PRESIDENT)
(309) 585-6061
Entity
Organization
Contact information
Practice address
208 S 1ST AVE, MORTON, IL 61550-2044
(309) 585-6061
Mailing address
147 MAPLE RIDGE DR, MORTON, IL 61550-1121
(309) 712-6396
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/09/2021
Last updated
05/09/2021
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