Individual
SUZANNE RENAE ROACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MCD, CCC-SLP
Contact information
Practice address
4320 ANNADALE CIR, JONESBORO, AR 72404-9508
(870) 931-9374
Mailing address
4320 ANNADALE CIR, JONESBORO, AR 72404-9508
(870) 931-9374
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP1968
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5X140
BLUE CROSS
AR
Enumeration date
11/01/2006
Last updated
07/08/2007
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