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Individual

MICHELLE LEE ROGERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW, LGSW

Contact information

Practice address
11141 ZEALAND AVE N, CHAMPLIN, MN 55316-3595
(763) 951-3091
(763) 951-3097
Mailing address
11141 ZEALAND AVE N, CHAMPLIN, MN 55316-3595
(763) 951-3091
(763) 951-3097

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
22733
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
22733
LGSW
MN
Enumeration date
10/04/2022
Last updated
10/04/2022
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