| NPI | 1447304555 |
|---|---|
| Former Name | ROLESIA RENEE ROGERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC5072) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD LCA1623) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2016-09-07 |