Provider Demographics
NPI:1487981882
Name:THOMAS, ROCHELLE SAMANTHA (SLP)
Entity type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:SAMANTHA
Last Name:THOMAS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 W 74TH ST APT 1011
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-2355
Mailing Address - Country:US
Mailing Address - Phone:734-308-0123
Mailing Address - Fax:
Practice Address - Street 1:ALL IN ONE SPOT WITH THERATALK
Practice Address - Street 2:150-50 14TH RD
Practice Address - City:WHITE STONE
Practice Address - State:NY
Practice Address - Zip Code:11357
Practice Address - Country:US
Practice Address - Phone:718-767-0091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019461-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist