Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 001168 | IA |
NPI | 1003142209 |
---|---|
Provider Name | Patricia A Rogness |
First Address | Des Moines, IA 50314-2329 |
Second Address | Des Moines, IA 50314-2329 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/10/2009 |
Last Update Date | 22/10/2009 |