Individual
DANIEL STEPHEN ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, CBIS
Contact information
Practice address
2579 JOHN MILTON DR, HERNDON, VA 20171-2563
(703) 214-4924
Mailing address
1549 INLET CT, RESTON, VA 20190-4423
(301) 466-5503
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/28/2024
Last updated
06/06/2024
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