Provider Demographics
NPI:1376043935
Name:ROGERS, SARAH ALEXANDRIA
Entity Type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:ALEXANDRIA
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 1:16005 VERGI CT
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-4180
Mailing Address - Country:US
Mailing Address - Phone:586-536-3643
Mailing Address - Fax:
Practice Address - Street 1:16005 VERGI CT
Practice Address - Street 2:
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48038-4180
Practice Address - Country:US
Practice Address - Phone:586-536-3643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-20
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5201009222OtherOCCUPATIONAL THERAPIST