Individual
MS. REBECCA ANN DEROCHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC, CAAC-R
Contact information
Practice address
940 E 8TH ST, TRAVERSE CITY, MI 49686-2893
(231) 922-4810
Mailing address
407 GEORGE ST, TRAVERSE CITY, MI 49686-4811
(231) 590-2047
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
6401009909
MI
Other
Enumeration date
02/04/2010
Last updated
02/04/2010
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