| NPI | 1982289096 |
|---|---|
| Former Name | ALEXIS REANNE ROGERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-03-10 |
| Last Update Date | 2021-06-18 |