Provider Demographics
NPI:1740352509
Name:BURNS, ROCHELLE (MA)
Entity type:Individual
Prefix:MS
First Name:ROCHELLE
Middle Name:
Last Name:BURNS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:SHELLEY
Other - Middle Name:
Other - Last Name:BURNS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:PO BOX 1688
Mailing Address - Street 2:
Mailing Address - City:DUVALL
Mailing Address - State:WA
Mailing Address - Zip Code:98019-1688
Mailing Address - Country:US
Mailing Address - Phone:425-844-2103
Mailing Address - Fax:425-788-3917
Practice Address - Street 1:26425 NE ALLEN ST
Practice Address - Street 2:SUITE 103A
Practice Address - City:DUVALL
Practice Address - State:WA
Practice Address - Zip Code:98019-8612
Practice Address - Country:US
Practice Address - Phone:425-844-2103
Practice Address - Fax:425-788-3917
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005879101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health