Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor |
NPI | 1013311638 |
---|---|
Provider Name | Viola Roth |
First Address | Indianapolis, IN 46241-5042 |
Second Address | Indianapolis, IN 46241-5042 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2014 |
Last Update Date | 13/10/2014 |