Healthcare Provider Details

I. General information

NPI: 1760926828
Provider Name (Legal Business Name): DENISSE OCH RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2016
Last Update Date: 08/25/2022
Certification Date: 08/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1532 SW MAPP RD
PALM CITY FL
34990-2446
US

IV. Provider business mailing address

1532 SW MAPP RD
PALM CITY FL
34990-2446
US

V. Phone/Fax

Practice location:
  • Phone: 772-678-6704
  • Fax:
Mailing address:
  • Phone: 772-678-6704
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-19-106128
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: