Individual
SAMANTHA M ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1015 GAMMON LN, MADISON, WI 53719-2210
(608) 417-8158
Mailing address
1015 GAMMON LN, MADISON, WI 53719-2210
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
10111-123
WI
1041C0700X
Clinical Social Worker
Primary
10111-123
WI
Other
Enumeration date
12/18/2020
Last updated
09/27/2023
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