Provider Demographics
NPI:1417497579
Name:ROGHANI, PARNIA
Entity Type:Individual
Prefix:
First Name:PARNIA
Middle Name:
Last Name:ROGHANI
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 1:3461 BURLINGTON AVE N
Mailing Address - Street 2:APT 11
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-8548
Mailing Address - Country:US
Mailing Address - Phone:727-328-4005
Mailing Address - Fax:727-258-9073
Practice Address - Street 1:3461 BURLINGTON AVE N
Practice Address - Street 2:APT 11
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-8548
Practice Address - Country:US
Practice Address - Phone:727-328-4005
Practice Address - Fax:727-258-9073
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health