Provider Demographics
NPI:1285121806
Name:TROCHE, SIXTO REY SR (CADC)
Entity type:Individual
Prefix:
First Name:SIXTO
Middle Name:REY
Last Name:TROCHE
Suffix:SR
Gender:M
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2205 SILVERSIDE RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-4534
Mailing Address - Country:US
Mailing Address - Phone:302-475-2700
Mailing Address - Fax:302-475-0200
Practice Address - Street 1:2205 SILVERSIDE RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4534
Practice Address - Country:US
Practice Address - Phone:302-475-2700
Practice Address - Fax:302-475-0200
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-19
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE1692101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty