| Doctor Name: | JESSICA JEAN DEROCHE |
| NPI Number: | 1023256583 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.ED. |
| License Number: | 61440 |
| Business Practice Address: | 571 S Edmonds Ln Ste 102 Lewisville, TX - 750673645 |
| Business Phone Number: | 9724363118 |
| Business Fax Number: | 9724534259 |
| Mailing Address: | 571 S Edmonds Ln Ste 102, LEWISVILLE |
| State: | TX |
| Postal Code: | 750673645 |
| Phone Number: | 9724363118 |
| Fax Number: | 9724534259 |
| NPI Enumeration Date: | 01/21/2009 |
| NPI Last Update Date: | 01/21/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 61440 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |