Provider Demographics
NPI:1730970385
Name:OROCK, BONAVENTURE
Entity type:Individual
Prefix:
First Name:BONAVENTURE
Middle Name:
Last Name:OROCK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12234 APACHE TEARS CIR
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-2847
Mailing Address - Country:US
Mailing Address - Phone:240-784-3133
Mailing Address - Fax:
Practice Address - Street 1:12234 APACHE TEARS CIR
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-2847
Practice Address - Country:US
Practice Address - Phone:240-784-3133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-14
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No376K00000XNursing Service Related ProvidersNurse's Aide