Provider Demographics
NPI:1154184810
Name:ROCHON, BRYANT D SR
Entity type:Individual
Prefix:MR
First Name:BRYANT
Middle Name:D
Last Name:ROCHON
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2102 SADDLECREEK DR
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-8947
Mailing Address - Country:US
Mailing Address - Phone:404-916-2445
Mailing Address - Fax:
Practice Address - Street 1:2102 SADDLECREEK DR
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-8947
Practice Address - Country:US
Practice Address - Phone:404-916-2445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker