MEDICARE: MICHELLE ROCHA MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	18092	AZ

General Provider Information

NPI Number	:	1154933067
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE ROCHA MSW

Provider Business Mailing Address
First Line	:	5912 KIT COVE CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-2088
Country	:	US
Telephone Number	:	801-234-0219
Fax Number	:

Provider Business Practice Location Address
First Line	:	5912 KIT COVE CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-2088
Country	:	US
Telephone Number	:	801-234-0219
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2020
Last Update Date	:	08/21/2020

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Directions to “ MICHELLE ROCHA MSW” Practice Location

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