Individual
AMBER ELLEN ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1395 E ORANGE GROVE BLVD, PASADENA, CA 91104-3039
(626) 255-5874
Mailing address
513 E LIME AVE, MONROVIA, CA 91016-2982
(626) 255-5874
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
31465
CA
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
03/26/2007
Last updated
04/25/2012
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