Provider Demographics
NPI:1811501893
Name:MARGARET ROTH, INC
Entity type:Organization
Organization Name:MARGARET ROTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:GAYLE
Authorized Official - Last Name:ROTH
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:540-447-0031
Mailing Address - Street 1:PO BOX 1352
Mailing Address - Street 2:
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24402-1352
Mailing Address - Country:US
Mailing Address - Phone:540-447-0031
Mailing Address - Fax:
Practice Address - Street 1:2303 N AUGUSTA ST STE D
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-2597
Practice Address - Country:US
Practice Address - Phone:540-447-0031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-07
Last Update Date:2020-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty