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General NPI Number Information
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NPI Number | 1023963329
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Entity Type | Individual
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Provider Name | DEVON ROACH RBT
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Gender | Female
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Dates
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Enumeration Date | 03/02/2026
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Last Update Date | 03/02/2026
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Provider Practice Location Address
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Address Line | 619 N 30TH ST
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City | PADUCAH
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State | KY
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Zip | 42001-4047
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Country | US
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Telephone | 270-444-7898
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Fax | 270-933-1786
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Provider Business Mailing Address
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Address Line | 257 EM HURLEY LN
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City | CALVERT CITY
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State | KY
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Zip | 42029-8874
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Country | US
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Telephone | 270-444-7898
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Fax | 270-933-1786
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-26-516559
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License Number State | KY
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