Provider Demographics
NPI:1992302111
Name:COUSINEAU POPE, ROCHELLE ANTOINETTE (LMFTA)
Entity type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:ANTOINETTE
Last Name:COUSINEAU POPE
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11726 N FAIRWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-2927
Mailing Address - Country:US
Mailing Address - Phone:775-225-4840
Mailing Address - Fax:
Practice Address - Street 1:8121 W QUINAULT AVE STE F202
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-8210
Practice Address - Country:US
Practice Address - Phone:509-579-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMG61090969106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist