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Individual

ROCHELLE ANDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3118 W T RYAN LN, PHOENIX, AZ 85041-5216
(602) 621-6337
(602) 601-7727
Mailing address
3118 W T RYAN LN, PHOENIX, AZ 85041-5216
(602) 621-6337
(602) 601-7727

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
AL9669H
AZ
310400000X
Assisted Living Facility
Primary
AL10582F
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
82-2200444
IRS
AZ
Enumeration date
11/13/2013
Last updated
03/17/2018
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