Provider Demographics
NPI:1437507118
Name:ROCHE, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:ROCHE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 E BROADWAY
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-4306
Mailing Address - Country:US
Mailing Address - Phone:978-914-0087
Mailing Address - Fax:
Practice Address - Street 1:280 E BROADWAY
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-4306
Practice Address - Country:US
Practice Address - Phone:978-914-0087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-02
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst