Provider Demographics
NPI:1053639609
Name:GRIER-ROGERS, ALEESHA DENISE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ALEESHA
Middle Name:DENISE
Last Name:GRIER-ROGERS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 LEATHERMAN TRL
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-2046
Mailing Address - Country:US
Mailing Address - Phone:203-516-0755
Mailing Address - Fax:203-503-3478
Practice Address - Street 1:10 MAIN ST
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-2403
Practice Address - Country:US
Practice Address - Phone:203-516-0755
Practice Address - Fax:203-503-3478
Is Sole Proprietor?:No
Enumeration Date:2010-05-06
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003271103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004235918Medicaid