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Individual
ROGER MACK PUMPHREY
Active
Individual
ROGER MACK PUMPHREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1328-125
WI
101YP2500X
Professional Counselor
1157-132
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39668000
—
WI
Enumeration date
07/24/2007
Last updated
07/24/2007
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