Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 3240 | AZ |
N | 103TC0700X | Clinical Psychologist | 3240 | AZ |
N | 102L00000X | Psychologist | 3240 | AZ |
N | 103T00000X | Psychologist | 3240 | AZ |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 3240 | AZ |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 3240 | AZ |
N | 103G00000X | Clinical Psychologist | 3240 | AZ |
N | 103TC0700X | Clinical Psychologist | 3240 | AZ |
N | 103TF0200X | Forensic Psychologist | 3240 | AZ |
N | 103TH0100X | Health Service | 3240 | AZ |
Y | 103TR0400X | Rehabilitation Psychologist | PSY-003240 | AZ |
NPI | 1700923299 |
---|---|
Provider Name | Sari Roth-Roemer |
First Address | Phoenix, AZ 85013-4423 |
Second Address | Phoenix, AZ 85013-4423 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2007 |
Last Update Date | 03/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S19736 | (02) | AZ |