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Individual

NICOLE M ROGERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS/SLP

Contact information

Practice address
902 CHATHAM CT, CHARLOTTESVILLE, VA 22901-1741
(141) 449-4592
(434) 979-8536
Mailing address
902 CHATHAM CT, CHARLOTTESVILLE, VA 22901-1741
(141) 449-4592
(434) 979-8536

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202006334
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4980671
VA
Enumeration date
04/17/2012
Last updated
04/17/2012
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