Individual
KITTIE A ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
2100 E BROADWAY STE 217B, COLUMBIA, MO 65201-6082
(573) 529-0732
Mailing address
504 N WILLIAM ST, COLUMBIA, MO 65201-5654
(573) 529-0732
(573) 875-3183
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
002690
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
187340
BCBS
MO
05
—
497810218
—
MO
01
—
506201904
HCY MEDICAID NUMBER
MO
Enumeration date
07/19/2005
Last updated
10/25/2020
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