Individual
SAMUEL ROGERS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2840 ELECTRIC RD STE 200, ROANOKE, VA 24018-3551
(540) 772-5153
(540) 772-5158
Mailing address
2727 ELECTRIC RD, SUITE 100, ROANOKE, VA 24018-3547
(540) 772-5153
(540) 772-5157
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810001141
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010279569
—
VA
Enumeration date
02/01/2006
Last updated
06/19/2019
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