Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 0134000397 | VA |
N | 106S00000X | Behavior Technician |
NPI | 1043862147 |
---|---|
Provider Name | Promises Rogers |
First Address | Dumfries, VA 22026-2456 |
Second Address | Fredericksburg, VA 22401-5801 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2019 |
Last Update Date | 11/11/2021 |