Provider Demographics
NPI:1679627574
Name:ROCHNA, DEBRA LYNN (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:LYNN
Last Name:ROCHNA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:DEBRA
Other - Middle Name:LYNN
Other - Last Name:RIDDLE-MEERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, CSW
Mailing Address - Street 1:1980 AUSTIN DR
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-1904
Mailing Address - Country:US
Mailing Address - Phone:313-531-2500
Mailing Address - Fax:313-255-3471
Practice Address - Street 1:24424 W MCNICHOLS RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48219-3653
Practice Address - Country:US
Practice Address - Phone:313-531-2500
Practice Address - Fax:313-255-3471
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010646911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIDR064691OtherBCBS PIN