Individual
JUDI TAYLOR ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
100 MARINERS DR STE D, KINGSLAND, GA 31548-6667
(770) 656-4401
(386) 283-4170
Mailing address
90 SAN JUAN DR APT B104, PALM COAST, FL 32137-2368
(770) 331-9344
(386) 283-4170
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW002516
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00851023B
—
GA
Enumeration date
01/11/2007
Last updated
03/16/2020
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