Individual
CANDY RENEA ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2025 BYPASS RD, BRANDENBURG, KY 40108-1605
(270) 422-3971
Mailing address
2025 BYPASS RD, BRANDENBURG, KY 40108-1605
(270) 422-3971
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
104100000X
Social Worker
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/13/2017
Last updated
07/28/2017
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