KANDACE ROTH
Social Worker - Clinical
Active
Individual
NPI: 1205184884
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Social Worker | 104100000X | No | - |
| Social Worker - Clinical | 1041C0700X | Yes | 149.023565 (IL) |
Frequently Asked Questions
NPI 1205184884 is the National Provider Identifier for KANDACE ROTH, a Social Worker - Clinical provider located in East Peoria, IL. This NPI was enumerated on August 29, 2012.
KANDACE ROTH practices at 411 E WASHINGTON ST, East Peoria, IL 61611.
Quick Facts
- NPI
- 1205184884
- Type
- Individual
- Enumerated
- Aug 29, 2012
- Last Updated
- Jul 28, 2021
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