Individual
MRS. LICIA WILLIAMS ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPA
Contact information
Practice address
4020 OLEANDER DR STE 203, WILMINGTON, NC 28403-6850
(910) 540-8081
(910) 399-3434
Mailing address
4020 OLEANDER DR STE 203, WILMINGTON, NC 28403-6850
(910) 540-8081
(910) 399-3434
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1980
NC
103TC0700X
Clinical Psychologist
Primary
1980
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6107193
—
NC
Enumeration date
09/28/2006
Last updated
06/12/2020
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