Individual
MRS. HEATHER L. ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
1110 CALL CREEK DR STE 7, POCATELLO, ID 83201-3072
(208) 233-4660
(208) 233-4262
Mailing address
1165 ENCINO ST, POCATELLO, ID 83201-2865
(208) 238-2675
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12075292
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010156481
REGENCE BLUE SHIELD OF ID
HI
01
—
12075292
ASHA NUMBER
—
Enumeration date
01/17/2007
Last updated
07/08/2007
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