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General NPI Number Information
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NPI Number | 1427475060
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Entity Type | Individual
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Provider Name | HAYLEY ROTH
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Gender | Female
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Dates
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Enumeration Date | 03/20/2014
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 9819 S 168TH AVE STE 6B
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City | OMAHA
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State | NE
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Zip | 68136-1154
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Country | US
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Telephone | 402-590-8932
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Fax |
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Provider Business Mailing Address
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Address Line | 9565 S 183RD AVE
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City | OMAHA
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State | NE
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Zip | 68136-6537
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Country | US
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Telephone | 641-821-0404
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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 | 5104
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 3838
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 008417
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License Number State | IA
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