Provider Demographics
NPI:1205449303
Name:ROCHESTER THERAPY CENTER
Entity type:Organization
Organization Name:ROCHESTER THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST AND NEUROTHERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DANA
Authorized Official - Middle Name:L
Authorized Official - Last Name:PHENIX
Authorized Official - Suffix:
Authorized Official - Credentials:DFMFT
Authorized Official - Phone:507-273-3768
Mailing Address - Street 1:74823 260TH AVE
Mailing Address - Street 2:
Mailing Address - City:HAYFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55940-8403
Mailing Address - Country:US
Mailing Address - Phone:507-273-3768
Mailing Address - Fax:
Practice Address - Street 1:1530 GREENVIEW DR SW STE 113
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55902-1080
Practice Address - Country:US
Practice Address - Phone:507-273-3768
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty