Individual
BRANDY B ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC, LADC, PMH-C
Contact information
Practice address
15 YORK ST UNIT 201H, BIDDEFORD, ME 04005-5534
(207) 749-4620
Mailing address
15 YORK ST UNIT 201H, BIDDEFORD, ME 04005-5534
(207) 749-4620
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC4011
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114367760
NPI
ME
Enumeration date
09/24/2010
Last updated
10/01/2021
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