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Individual

LATRELLE ROGERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BCBA

Contact information

Practice address
7809 SARDIS RD, CHARLOTTE, NC 28270-2757
(704) 619-6565
Mailing address
7809 SARDIS RD, CHARLOTTE, NC 28270-2757
(704) 619-6565

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
310
NC
103K00000X
Behavior Analyst
Primary
1-18-30190
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1-18-30190
BCBA
NC
01
310
NORTH CAROLINA BOARD OF LICENSED CLINICAL PROFESSIONALS
NC
Enumeration date
09/10/2018
Last updated
07/04/2025
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