Individual
THERESA ADKINS ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MASTERS
Contact information
Practice address
1310 N HEARNE AVE, SHREVEPORT, LA 71107-6516
(318) 676-5111
Mailing address
10622 FERRY LAKE SCHOOL RD, OIL CITY, LA 71061-9628
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0728
OMH PROVIDER NUMBER
LA
Enumeration date
04/10/2007
Last updated
07/08/2007
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