Healthcare Provider Details

I. General information

NPI: 1710436951
Provider Name (Legal Business Name): DEANNA MOCCIA DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2016
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 HAMPTON CIR
ROCHESTER HILLS MI
48307-4103
US

IV. Provider business mailing address

141 HAMPTON CIR
ROCHESTER HILLS MI
48307-4103
US

V. Phone/Fax

Practice location:
  • Phone: 248-853-7555
  • Fax: 248-853-7556
Mailing address:
  • Phone: 248-853-7555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501303086
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number5501303086
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: