Individual
DOMINIC DEON ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
164 WACCAMAW MEDICAL PARK DR, CONWAY, SC 29526-8903
(843) 347-4888
Mailing address
164 WACCAMAW MEDICAL PARK DR, CONWAY, SC 29526-8903
(843) 347-4888
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/04/2012
Last updated
06/04/2012
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