Individual
NICOLE ANN ROSHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1502 ROUTE 61 HWY S, POTTSVILLE, PA 17901-8409
(570) 593-5484
Mailing address
836 WATER ST, POTTSVILLE, PA 17901-1110
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
PA
Other
Enumeration date
03/19/2020
Last updated
03/19/2020
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