Provider Demographics
NPI:1568653244
Name:GREENBAUM, ROCHELLE IRENE (MA)
Entity Type:Individual
Prefix:MS
First Name:ROCHELLE
Middle Name:IRENE
Last Name:GREENBAUM
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 1:30 W MISSION ST STE 1
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-0400
Mailing Address - Country:US
Mailing Address - Phone:805-569-9647
Mailing Address - Fax:
Practice Address - Street 1:30 W MISSION ST STE 1
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-0400
Practice Address - Country:US
Practice Address - Phone:805-569-9647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP4192235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist