Provider Demographics
NPI:1023468444
Name:FLUMENBAUM, ROCHELLE (PHD)
Entity type:Individual
Prefix:DR
First Name:ROCHELLE
Middle Name:
Last Name:FLUMENBAUM
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 PARKLAKE AVE
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-2052
Mailing Address - Country:US
Mailing Address - Phone:734-649-0466
Mailing Address - Fax:
Practice Address - Street 1:1955 PAULINE BLVD
Practice Address - Street 2:SUITE 100A
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-5003
Practice Address - Country:US
Practice Address - Phone:734-994-9466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-16
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301005218103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical