Provider Demographics
NPI:1972842623
Name:ST. ROCK, DONNA M (MA)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:ST. ROCK
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2260 PALM BEACH LAKES BLVD
Mailing Address - Street 2:SUITE 212
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-3411
Mailing Address - Country:US
Mailing Address - Phone:561-684-7300
Mailing Address - Fax:561-684-7450
Practice Address - Street 1:5001 S FLORIDA AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-2776
Practice Address - Country:US
Practice Address - Phone:561-684-7300
Practice Address - Fax:561-684-7450
Is Sole Proprietor?:No
Enumeration Date:2013-01-31
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor