Provider Demographics
NPI:1184830895
Name:ROCHE, NANCY H (MA)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:H
Last Name:ROCHE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 TULIP ST
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-2404
Mailing Address - Country:US
Mailing Address - Phone:908-277-7676
Mailing Address - Fax:
Practice Address - Street 1:9 TULIP ST
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-2404
Practice Address - Country:US
Practice Address - Phone:908-277-7676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00020400101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor