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NPI Code Detail

MEDICARE: DR. ROCHELLE BETTYJEAN RALEIGH PHD

MEDICARE:  DR. ROCHELLE BETTYJEAN RALEIGH  PHD
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
1101YM0800XMental Health Counselor072161070509FL
2103TP2701XGroup Psychotherapy Psychologist072161070509FL
3106H00000XMarriage & Family Therapist072161070509FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1072161070509OTHERFLPRIVATE PAY

General Provider Information

NPI Number : 1902188246
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROCHELLE BETTYJEAN RALEIGH PHD
Provider Business Mailing Address
First Line : 6219 WASHINGTON AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19143-2916
Country : US
Telephone Number : 267-444-8448
Fax Number :
Provider Business Practice Location Address
First Line : 6219 WASHINGTON AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19143-2916
Country : US
Telephone Number : 267-444-8448
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2011
Last Update Date : 09/13/2011

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