Provider Demographics
NPI:1255199261
Name:ROC, RICKIA E (RBT)
Entity type:Individual
Prefix:
First Name:RICKIA
Middle Name:E
Last Name:ROC
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 PLEASANT HILL RD APT 1917
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-4167
Mailing Address - Country:US
Mailing Address - Phone:203-550-5800
Mailing Address - Fax:
Practice Address - Street 1:2500 PLEASANT HILL RD APT 1917
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-4167
Practice Address - Country:US
Practice Address - Phone:203-550-5800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARBT-24-331805106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician