Provider Demographics
NPI:1801773247
Name:ROCHE, LAURA (APC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:ROCHE
Suffix:
Gender:F
Credentials:APC
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:BRANCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3565 PIEDMONT RD NE BLDG 2
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-8202
Mailing Address - Country:US
Mailing Address - Phone:404-282-3572
Mailing Address - Fax:
Practice Address - Street 1:3565 PIEDMONT RD NE BLDG 2
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-8202
Practice Address - Country:US
Practice Address - Phone:404-267-1517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC010156101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health