MEDICARE: ALYSSA N ROCHON MS, MFT-INTERN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MI4362	NV

General Provider Information

NPI Number	:	1457104911
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA N ROCHON MS, MFT-INTERN

Provider Business Mailing Address
First Line	:	10655 PARK RUN DR STE 210
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89144-4590
Country	:	US
Telephone Number	:	504-214-1915
Fax Number	:

Provider Business Practice Location Address
First Line	:	10655 PARK RUN DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89144-4589
Country	:	US
Telephone Number	:	702-608-1436
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2024
Last Update Date	:	04/08/2024

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