Healthcare Provider Details

I. General information

NPI: 1568955482
Provider Name (Legal Business Name): SAMANTHA L ROCHFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2018
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2970 N LITCHFIELD RD STE 110
GOODYEAR AZ
85395-7831
US

IV. Provider business mailing address

15333 N PIMA RD STE 305
SCOTTSDALE AZ
85260-2717
US

V. Phone/Fax

Practice location:
  • Phone: 480-769-5302
  • Fax:
Mailing address:
  • Phone: 480-769-5302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBEH-000728
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-18-57540
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: