Randy Scott Roth
Clinical Psychologist Rehabilitation Psychologist
325 E Eisenhower Pkwy
Ann Arbor
, Michigan 48108-3364
Randy Scott Roth
Clinical Psychologist Rehabilitation Psychologist
325 E Eisenhower Pkwy
Ann Arbor
, Michigan 48108-3364
(734) 647-5299
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About
Features
Specialties
- Clinical Psychologist
- Rehabilitation Psychologist
Languages spoken
- English
Location
First Address
- Randy Scott Roth
- 3621 S State St
- Ann Arbor, MI
- Zip : 48108-1633
- Phone : (734) 647-5299
Second Address
- Randy Scott Roth
- 325 E Eisenhower Pkwy
- Ann Arbor, MI
- Zip : 48108-3364
- Phone : (734) 936-7175
Reviews
FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103G00000X | Clinical Psychologist | 6301005458 | MI |
| Y | 103TC0700X | Clinical Psychologist | 6301005458 | MI |
| N | 103TR0400X | Rehabilitation Psychologist | 6301005458 | MI |
National Provider Identifier
| NPI | 1093892622 |
|---|---|
| Provider Name | Randy Scott Roth |
| First Address | Ann Arbor, MI 48108-1633 |
| Second Address | Ann Arbor, MI 48108-3364 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 01/11/2006 |
| Last Update Date | 11/11/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| R66769 | (02) | MI |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.