Provider Demographics
NPI:1598208365
Name:VENTURA-ROCHEZ, IMARI (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:IMARI
Middle Name:
Last Name:VENTURA-ROCHEZ
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:MRS
Other - First Name:IMARI
Other - Middle Name:
Other - Last Name:VENTURA-ROCHEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5610 NETHERLAND AVE
Mailing Address - Street 2:APT. 1A
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-1703
Mailing Address - Country:US
Mailing Address - Phone:718-757-9908
Mailing Address - Fax:
Practice Address - Street 1:1257 OGDEN AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-2905
Practice Address - Country:US
Practice Address - Phone:718-681-7553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-29
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021776235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist