Provider Demographics
NPI:1295200699
Name:AROCHO, WANDA IVELISSE (MSW)
Entity Type:Individual
Prefix:
First Name:WANDA
Middle Name:IVELISSE
Last Name:AROCHO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3402 ECHO RIDGE PL
Mailing Address - Street 2:
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32926-7402
Mailing Address - Country:US
Mailing Address - Phone:321-223-9744
Mailing Address - Fax:
Practice Address - Street 1:3402 ECHO RIDGE PL
Practice Address - Street 2:
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32926-7402
Practice Address - Country:US
Practice Address - Phone:321-223-9744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-11
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical