Provider Demographics
NPI:1326604950
Name:ROGERSON, MOLLY CATHERINE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MOLLY
Middle Name:CATHERINE
Last Name:ROGERSON
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MISS
Other - First Name:MOLLY
Other - Middle Name:CATHERINE
Other - Last Name:RUFFO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:70 KUKUK LN
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-6943
Mailing Address - Country:US
Mailing Address - Phone:518-813-0996
Mailing Address - Fax:
Practice Address - Street 1:70 KUKUK LN
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-6943
Practice Address - Country:US
Practice Address - Phone:845-336-2616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-20
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028732-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist