Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003315086 |
---|---|
Provider Name | Erin Nicole Rogers |
First Address | St Petersburg, FL 33701-4904 |
Second Address | St Petersburg, FL 33702 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2018 |
Last Update Date | 17/03/2018 |