Amanda Roth, LLC

NPI #1295448256 in Cody, Wyoming

Provider Information

NPI Number: 1295448256
Entity Type: Organization
Organization Name: Amanda Roth, LLC
Primary Specialty: Counselor - Mental Health
Enumeration Date: Jan 4, 2023
Last Updated: Jan 4, 2023

Practice Location

Address: 956 12TH ST
City: Cody
State: Wyoming
ZIP Code: 82414-3602
Phone: (307) 751-5111

Authorized Official

Name: AMANDA ROTH, LPC
Title: OWNER / COUNSELOR
Phone: (307) 751-5111

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X
Clinic/Center - Adult Mental Health — Adult Mental Health	261QM0850X
Clinic/Center - Adolescent and Children Mental Health — Adolescent and Children Mental Health	261QM0855X
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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