Provider Demographics
NPI:1114789799
Name:ALROKH, OLA (MS)
Entity Type:Individual
Prefix:
First Name:OLA
Middle Name:
Last Name:ALROKH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2563 DOC LOFTIN RD
Mailing Address - Street 2:
Mailing Address - City:AYDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28513-8559
Mailing Address - Country:US
Mailing Address - Phone:816-308-1144
Mailing Address - Fax:
Practice Address - Street 1:2563 DOC LOFTIN RD
Practice Address - Street 2:
Practice Address - City:AYDEN
Practice Address - State:NC
Practice Address - Zip Code:28513-8559
Practice Address - Country:US
Practice Address - Phone:816-308-1144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA19529101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional