Provider Demographics
NPI:1205182698
Name:ROGERS, DOROTHEA MAY
Entity Type:Individual
Prefix:DR
First Name:DOROTHEA
Middle Name:MAY
Last Name:ROGERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1845 MILLVILLE ROAD
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-7618
Mailing Address - Country:US
Mailing Address - Phone:810-938-5234
Mailing Address - Fax:
Practice Address - Street 1:1845 MILLVILLE ROAD
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-7618
Practice Address - Country:US
Practice Address - Phone:810-938-5234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-03
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4101006472106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist