Individual
DESTANI LACOLE ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSWA
Contact information
Practice address
5700 EXECUTIVE CENTER DR STE 110, CHARLOTTE, NC 28212-8833
(866) 272-7826
Mailing address
1260 MELON COLONY AVE SW, CONCORD, NC 28027-0265
(704) 960-3942
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P018412
NC
Other
Enumeration date
11/08/2022
Last updated
11/08/2022
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