Individual
AMANDA ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4714 FM 1488 RD STE 117, CONROE, TX 77384-4929
(936) 320-6389
Mailing address
4714 FM 1488 RD STE 117, CONROE, TX 77384-4929
(936) 320-6389
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
56614
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56614
LICENSED CLINICAL SOCIAL WORKER
TX
Enumeration date
10/02/2018
Last updated
10/02/2018
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