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General NPI Number Information
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NPI Number | 1255129201
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Entity Type | Individual
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Provider Name | JEANNETTE ROLDAN
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Gender | Female
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Dates
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Enumeration Date | 04/29/2025
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 609 S NEW HOPE RD STE 102
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City | GASTONIA
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State | NC
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Zip | 28054-4825
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Country | US
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Telephone | 704-412-2403
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Fax |
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Provider Business Mailing Address
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Address Line | 2682 LANDING POINTE DR
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City | CLOVER
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State | SC
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Zip | 29710-8075
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Country | US
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Telephone | 839-232-6543
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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