Provider Demographics
NPI:1114177318
Name:DANLEY, ROCHELLE L
Entity Type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:L
Last Name:DANLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 W 500 S
Mailing Address - Street 2:PO BOX 1908
Mailing Address - City:VERNAL
Mailing Address - State:UT
Mailing Address - Zip Code:84078-2914
Mailing Address - Country:US
Mailing Address - Phone:435-789-6300
Mailing Address - Fax:435-789-6325
Practice Address - Street 1:285 W 800 S
Practice Address - Street 2:
Practice Address - City:ROOSEVELT
Practice Address - State:UT
Practice Address - Zip Code:84066-3707
Practice Address - Country:US
Practice Address - Phone:435-725-6300
Practice Address - Fax:435-725-6325
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7021736-6009101Y00000X
UT7021763-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor