Individual
LAURA ROACHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED
Contact information
Practice address
1632 W DIAMOND ST, PHILADELPHIA, PA 19121-2313
(215) 763-3684
Mailing address
5013 N CAMAC ST, PHILADELPHIA, PA 19141-3521
(215) 763-3680
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
01974330
PA
Other
Enumeration date
02/06/2007
Last updated
07/08/2007
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