Provider Demographics
NPI:1740430982
Name:ENDFINGER, ROCKLYN
Entity Type:Individual
Prefix:
First Name:ROCKLYN
Middle Name:
Last Name:ENDFINGER
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 1:1708 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:KY
Mailing Address - Zip Code:41008-8775
Mailing Address - Country:US
Mailing Address - Phone:502-732-9331
Mailing Address - Fax:
Practice Address - Street 1:1708 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:KY
Practice Address - Zip Code:41008-8775
Practice Address - Country:US
Practice Address - Phone:502-732-9331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY610661458OtherGROUP TAX ID NUMBER