Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225CA2400X | Assistive Technology Practitioner |
NPI | 1255459442 |
---|---|
Provider Name | Ms. Deborrah Rogers |
First Address | Los Angeles, CA 90043-4064 |
Second Address | Los Angeles, CA 90040-2418 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 08/07/2007 |