Provider Demographics
NPI:1891906301
Name:LAROCHE, MAUDE (MSW)
Entity Type:Individual
Prefix:
First Name:MAUDE
Middle Name:
Last Name:LAROCHE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 PARTRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02145-3628
Mailing Address - Country:US
Mailing Address - Phone:617-623-7941
Mailing Address - Fax:
Practice Address - Street 1:366 SOMERVILLE AVE
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-2919
Practice Address - Country:US
Practice Address - Phone:617-628-8815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical