Provider Demographics
NPI:1225375900
Name:ROGERS, DOROTHY MARIE (LM, CPM)
Entity Type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:MARIE
Last Name:ROGERS
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 824
Mailing Address - Street 2:
Mailing Address - City:TUOLUMNE
Mailing Address - State:CA
Mailing Address - Zip Code:95379-0824
Mailing Address - Country:US
Mailing Address - Phone:209-352-0809
Mailing Address - Fax:
Practice Address - Street 1:18201 JACOBS RD
Practice Address - Street 2:
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-8619
Practice Address - Country:US
Practice Address - Phone:209-352-0809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-14
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM352176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife