| Doctor Name: | MRS. ROCHELLE RENEE PARK |
| NPI Number: | 1518020338 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, LPC, LPCC |
| License Number: | 0116501 |
| Business Practice Address: | 28000 Road T Dolores, CO - 813239203 |
| Business Phone Number: | 9708821253 |
| Business Fax Number: | 9708821500 |
| Mailing Address: | 91 Logging Trail Rd, DURANGO |
| State: | CO |
| Postal Code: | 813033625 |
| Phone Number: | 9702599284 |
| Fax Number: | |
| NPI Enumeration Date: | 12/19/2006 |
| NPI Last Update Date: | 05/28/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 0116501 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NM |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |