Provider Demographics
NPI:1285780353
Name:SOFFER, ROCHELLE L (MA, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:ROCHELLE
Middle Name:L
Last Name:SOFFER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7674 COURTYARD RUN W
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3006
Mailing Address - Country:US
Mailing Address - Phone:352-665-5867
Mailing Address - Fax:
Practice Address - Street 1:7522 WILES RD
Practice Address - Street 2:SUITE 208
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-2062
Practice Address - Country:US
Practice Address - Phone:954-227-8255
Practice Address - Fax:954-227-3566
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL889765400235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL889765400Medicaid