Provider Demographics
NPI:1942570494
Name:HEAD-DUNHAM, ROCHELLE LATRICE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROCHELLE
Middle Name:LATRICE
Last Name:HEAD-DUNHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ROCHELLE
Other - Middle Name:
Other - Last Name:DUNHAM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:7313 DOWNMAN RD
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70126-1213
Mailing Address - Country:US
Mailing Address - Phone:225-342-8916
Mailing Address - Fax:225-342-3875
Practice Address - Street 1:7313 DOWNMAN RD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70126-1213
Practice Address - Country:US
Practice Address - Phone:225-342-8916
Practice Address - Fax:225-342-3875
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-30
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA08387R2084P0800X, 2084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry