Individual
DR. DEBRA C. ROACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1357 MONROE AVE, ROCHESTER, NY 14618-1005
(585) 442-9601
(585) 442-9606
Mailing address
1357 MONROE AVE, ROCHESTER, NY 14618-1005
(585) 442-9601
(585) 442-9606
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
008455
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005694336
AETNA PROVIDER #
NY
01
—
103240FC
PREFERRED CARE PROVIDER #
NY
01
—
P010008455
EXCELLUS PROVIDER #
NY
Enumeration date
05/20/2006
Last updated
10/18/2011
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