Individual
MS. LISE G ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, NCC
Contact information
Practice address
202 NW 11TH ST, AVA, MO 65608
(417) 425-5533
(417) 725-6206
Mailing address
1978 W BUENA VISTA ST, SPRINGFIELD, MO 65810-1515
(417) 425-5533
(417) 725-6206
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
1999135684
MO
Other
Enumeration date
12/08/2006
Last updated
07/08/2007
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