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NPI Code Detail

MEDICARE: DIERDRA H ROLLER

MEDICARE: DIERDRA H ROLLER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor178.013300IL

General Provider Information

NPI Number : 1780555177
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIERDRA H ROLLER
Provider Business Mailing Address
First Line : 10308 WOODS EDGE DR
Second Line :
City : FISHERS
State : IN
Zip : 46037-9353
Country : US
Telephone Number : 630-862-1256
Fax Number :
Provider Business Practice Location Address
First Line : 8150 BROOKVILLE RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46239-8903
Country : US
Telephone Number : 317-754-7784
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2025
Last Update Date : 09/17/2025

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Directions to “ DIERDRA H ROLLER ” Practice Location

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