Healthcare Provider Details

I. General information

NPI: 1114102035
Provider Name (Legal Business Name): ROCCO LEOPOLD NOCERA BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2008
Last Update Date: 03/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W SPRING ST
MARQUETTE MI
49855-4661
US

IV. Provider business mailing address

200 W SPRING ST
MARQUETTE MI
49855-4661
US

V. Phone/Fax

Practice location:
  • Phone: 906-225-7210
  • Fax:
Mailing address:
  • Phone: 906-233-1236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-07-3256
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: