Provider Demographics
NPI:1184187213
Name:ROGALSKY, DENA S (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:DENA
Middle Name:S
Last Name:ROGALSKY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4629 FAIRLOOP RUN
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33973-6078
Mailing Address - Country:US
Mailing Address - Phone:239-246-6646
Mailing Address - Fax:
Practice Address - Street 1:4629 FAIRLOOP RUN
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33973-6078
Practice Address - Country:US
Practice Address - Phone:239-246-6646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-06
Last Update Date:2019-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA6413235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist