Provider Demographics
NPI:1194577924
Name:ROLLE, AJA DANAE
Entity type:Individual
Prefix:MS
First Name:AJA
Middle Name:DANAE
Last Name:ROLLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 N VALLEY OAKS CIR
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-1725
Mailing Address - Country:US
Mailing Address - Phone:832-818-5206
Mailing Address - Fax:
Practice Address - Street 1:90 N VALLEY OAKS CIR
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77382-1725
Practice Address - Country:US
Practice Address - Phone:832-818-5206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator