Provider Demographics
NPI:1679076384
Name:BRIDGES, ROCHELLE K (BSW, QMHS)
Entity Type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:K
Last Name:BRIDGES
Suffix:
Gender:F
Credentials:BSW, QMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8311 S CLEVELAND MASSILLON RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:OH
Mailing Address - Zip Code:44216-9195
Mailing Address - Country:US
Mailing Address - Phone:330-990-2683
Mailing Address - Fax:
Practice Address - Street 1:567 E TURKEYFOOT LAKE RD STE A-1
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44319-4107
Practice Address - Country:US
Practice Address - Phone:330-990-2683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-09
Last Update Date:2018-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker