Provider Demographics
NPI:1619395142
Name:ROGERS, SARAH COLENE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:COLENE
Last Name:ROGERS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1134 DOW ST
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-2486
Mailing Address - Country:US
Mailing Address - Phone:615-624-4494
Mailing Address - Fax:615-823-2879
Practice Address - Street 1:1134 DOW ST
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-2486
Practice Address - Country:US
Practice Address - Phone:615-624-4494
Practice Address - Fax:615-823-2879
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-02
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3232103TC0700X
VA0810004955103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical