| NPI | 1053516724 |
|---|---|
| Former Name | TRACY LYNN ROGERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TH0100X Psychologist, Health Service |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071007798) |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2019-11-21 |