Roche, Theresa A
Roche, Theresa A is an sole proprietor health care provider with primary practice located at 763 River Glen Dr , O Fallon MO 63368-9647. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Roche, Theresa A can be contacted via phone (636) 244-1917.Contact Information
Primary practice address
763 River Glen Dr
O Fallon MO 63368-9647
Phone: (636) 244-1917
Fax: (636) 244-1917
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 2004008737 | Missouri |
Profile Details
| NPI number | 1215955463 |
|---|---|
| LBN Legal business name | Roche, Theresa A |
| Credentials | MSW,LCSW |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 17th, 2006 |
| Last updated | May 17th, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215955463 | NPPES |
| Missouri | MEDICAID | 497324103 |
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