Individual
KIMBERLY LYNN ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
745 S MILLEDGE AVE STE 1A, ATHENS, GA 30605-1292
(706) 498-9560
Mailing address
3584 ATLANTA HIGHWAY, FLOWERY BRANCH, GA 30542
(770) 535-1050
(678) 943-8705
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LPC004836
GA
101YA0400X
Addiction (Substance Use Disorder) Counselor
LPC004836
GA
101YP2500X
Professional Counselor
Primary
LPC004836
GA
Other
Enumeration date
04/10/2007
Last updated
11/19/2024
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