Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1255746681 |
---|---|
Provider Name | Miss Mari Rogers |
First Address | Sioux Falls, SD 57105-1305 |
Second Address | Sioux Falls, SD 57105-1305 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2014 |
Last Update Date | 24/06/2014 |