Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 9453 | TX |
NPI | 1003468059 |
---|---|
Provider Name | Pamela Anne Rogers |
First Address | Houston, TX 77070-4305 |
Second Address | Houston, TX 77070-4305 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2019 |
Last Update Date | 10/07/2019 |