Provider Demographics
NPI:1639293053
Name:PHILIPPS, ROCHELLE SCHAFFER
Entity Type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:SCHAFFER
Last Name:PHILIPPS
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 1:13814 EAGLES ROCK CT
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-6483
Mailing Address - Country:US
Mailing Address - Phone:727-868-0865
Mailing Address - Fax:
Practice Address - Street 1:7206 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-2934
Practice Address - Country:US
Practice Address - Phone:727-842-2223
Practice Address - Fax:727-842-2236
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA2725235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist