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Organization
THE FAMILY MENTAL HEALTH PRACTICE
Active
Organization
THE FAMILY MENTAL HEALTH PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THEODORE RICHARD DEROCHE PHD (OWNER PRIVATE PRACTICE)
(386) 439-1403
Entity
Organization
Contact information
Practice address
2760 SW 17TH ST, SUITE 300, OCALA, FL 34471
(352) 629-4113
(386) 439-1403
Mailing address
701 N CENTRAL AVENUE, FLAGLER BEACH, FL 32136
(386) 439-1403
(386) 439-1403
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH0000050
FL
Other
Enumeration date
10/29/2007
Last updated
11/27/2007
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