Provider Demographics
NPI:1477538288
Name:ROGERS, DONNA R (PHD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:R
Last Name:ROGERS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3317 PROSPECT PKWY
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-8359
Mailing Address - Country:US
Mailing Address - Phone:702-374-3282
Mailing Address - Fax:919-800-3060
Practice Address - Street 1:1140 HOLLY SPRINGS RD
Practice Address - Street 2:SUITE 207
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-9634
Practice Address - Country:US
Practice Address - Phone:919-802-0312
Practice Address - Fax:919-800-3060
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-14
Last Update Date:2023-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPY0332103TC0700X
NC4436103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002602088Medicaid
NC4436OtherNC STATE LICENSE
NC4436OtherNC STATE LICENSE