Provider Demographics
NPI:1215175310
Name:ROCKOFF, PHYLLIS G
Entity type:Individual
Prefix:MRS
First Name:PHYLLIS
Middle Name:G
Last Name:ROCKOFF
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 1:12 WATSON PKWY
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-1352
Mailing Address - Country:US
Mailing Address - Phone:978-750-8079
Mailing Address - Fax:
Practice Address - Street 1:12 WATSON PKWY
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-1352
Practice Address - Country:US
Practice Address - Phone:978-750-8079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-27
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health