Provider Demographics
NPI:1326549775
Name:TROCHE, LAURENE
Entity Type:Individual
Prefix:
First Name:LAURENE
Middle Name:
Last Name:TROCHE
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 1:2151 NW 82ND WAY
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33322-3951
Mailing Address - Country:US
Mailing Address - Phone:754-465-6411
Mailing Address - Fax:954-653-8625
Practice Address - Street 1:2245 MADISON ST APT 107
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-5305
Practice Address - Country:US
Practice Address - Phone:754-465-6411
Practice Address - Fax:954-653-8625
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-21
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician