Provider Demographics
NPI:1528194214
Name:ROGERS, DEBORAH K (MS)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:K
Last Name:ROGERS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 UNITED WAY
Mailing Address - Street 2:
Mailing Address - City:FREDERIC
Mailing Address - State:WI
Mailing Address - Zip Code:54837-8938
Mailing Address - Country:US
Mailing Address - Phone:715-327-4402
Mailing Address - Fax:715-327-8509
Practice Address - Street 1:225 SCHOLL CT
Practice Address - Street 2:
Practice Address - City:AMERY
Practice Address - State:WI
Practice Address - Zip Code:54001-1261
Practice Address - Country:US
Practice Address - Phone:715-327-4402
Practice Address - Fax:715-327-8509
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNHP76833OtherHEALTH PARTNERS
MN855751050815OtherPREFERRED ONE
WI43703600Medicaid
MN165D3ROOtherBCBS OF MN