Provider Demographics
NPI:1902436454
Name:ROCK, ALANA (CAT-LP, R-DMT)
Entity type:Individual
Prefix:
First Name:ALANA
Middle Name:
Last Name:ROCK
Suffix:
Gender:F
Credentials:CAT-LP, R-DMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1188 LINCOLN PL APT D4
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-3543
Mailing Address - Country:US
Mailing Address - Phone:913-706-9955
Mailing Address - Fax:
Practice Address - Street 1:1188 LINCOLN PL APT D4
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-3543
Practice Address - Country:US
Practice Address - Phone:913-706-9955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-23
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225600000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDance Therapist