Provider Demographics
NPI:1770028342
Name:JOHNSON-SMITH, ROCHELLE
Entity Type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:
Last Name:JOHNSON-SMITH
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 1:10730 GLENORA DR APT 208
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-3525
Mailing Address - Country:US
Mailing Address - Phone:832-401-8219
Mailing Address - Fax:
Practice Address - Street 1:14503 BAMMEL NORTH HOUSTON RD STE 210
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77014-1147
Practice Address - Country:US
Practice Address - Phone:832-401-8219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-05
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker