Grace Derocha, R.D., C.D.E

Registered Dietitian · Warren, MI

Individual Active NPI

NPI number 1659567592

Practice location

30158 Trailwood Dr
Warren, MI 48092-6304
Phone
(313) 570-1166

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NPI record

NPI
1659567592
Entity type
Individual (Type 1)
Enumeration date
September 24, 2007
Last updated
October 21, 2013
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Registered Dietitian Primary 133V00000X 886178 MI
Health Educator 174H00000X 20920243 MI

Mailing address

1333 Brewery Park Blvd
Suite 200
Detroit, MI 48207-4544
Phone
(313) 446-4444
Fax
(313) 446-4445

About Grace Derocha

Grace Derocha, R.D., C.D.E is a healthcare provider registered in the NPI registry with the primary taxonomy Registered Dietitian (code 133V00000X). The practice location is 30158 Trailwood Dr, Warren, MI 48092-6304. The NPI number 1659567592 was assigned on September 24, 2007 and the record was last updated on October 21, 2013.

Grace Derocha lists 2 licenses in the registry: #886178 (MI) for Registered Dietitian; #20920243 (MI) for Health Educator. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Grace Derocha, R.D., C.D.E?

The NPI number is 1659567592.

What is the phone number of Grace Derocha?

The phone number listed for the practice location is (313) 570-1166.

Where is Grace Derocha located?

30158 Trailwood Dr, Warren, MI 48092-6304.

What is the taxonomy code for Grace Derocha?

The primary taxonomy code is 133V00000X – Registered Dietitian; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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