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Individual

ALISCHA IESCHA RODGERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, LPC

Contact information

Practice address
301 MCCULLOUGH DR, 4TH FLOOR, CHARLOTTE, NC 28262-3310
(704) 909-2757
Mailing address
2538 PIMPERNEL RD, CHARLOTTE, NC 28213-9235
(704) 953-5875

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4946
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
139XC
BLUE CROSS BLUE SHIELD
NC
05
6102732
NC
Enumeration date
12/06/2006
Last updated
05/04/2009
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