Individual
MISS DELISA MICHELLE ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
625 NW 13TH ST, OKLAHOMA CITY, OK 73103-2239
(405) 601-2307
Mailing address
7713 NW 113TH PL, OKLAHOMA CITY, OK 73162-2542
(405) 615-4974
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200077440A
—
OK
Enumeration date
01/07/2013
Last updated
01/07/2013
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