NPI 1013036607
Theodore R Deroche, PHD
Practice location
- Address
- 2760 SE 17th Street Suite 300, Ocala, FL 34471
- Phone
- (352) 629-4113
- Fax
- (386) 439-1403
- Mailing address
- 701 North Central Ave, Flagler Beach, FL 32136
Registered specialties
Mental Health Counselor
Primary
Registry record
- NPI
- 1013036607
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 28 Mar 2007
- Record last updated
- 8 Jul 2007
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.