Individual
MARK ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1500 N. MARKET UNIT C SUITE 105, SHREVEPORT, LA 71107
(318) 626-5597
Mailing address
1500 N MARKET ST UNIT C, SHREVEPORT, LA 71107-6537
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/15/2017
Last updated
06/15/2017
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