Individual
MS. NICOLE ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
29858 N TATUM BLVD # 100, CAVE CREEK, AZ 85331-5865
(480) 923-6267
Mailing address
125 E GUADALUPE RD APT 11206, GILBERT, AZ 85234-4692
(480) 343-3763
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
19645
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
81261553
—
AZ
Enumeration date
03/21/2022
Last updated
03/21/2022
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