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NPI 1427055680

NPI 1427055680 : TANYA JOYCE ROCK LMSW : ATLANTA, MI

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General NPI Number Information
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    NPI Number           |    1427055680
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    Entity Type          |    Individual 
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    Provider Name        |    TANYA JOYCE ROCK LMSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/02/2005
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    Last Update Date     |    11/13/2016
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Provider Practice Location Address
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    Address Line         |    5375 E SANDY TRL 
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    City                 |    ATLANTA
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    State                |    MI
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    Zip                  |    49709-8956
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    Country              |    US
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    Telephone            |    989-785-4444
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    Fax                  |    989-785-4444
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Provider Business Mailing Address
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    Address Line         |    1921 MARSAC ST 
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    City                 |    BAY CITY
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    State                |    MI
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    Zip                  |    48708-8525
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    Country              |    US
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    Telephone            |    989-619-8910
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    6801066400
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    License Number State |    MI
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