Provider Demographics
NPI:1689425910
Name:ROGERS, MARIA THERESA (RDN, LDN)
Entity Type:Individual
Prefix:MS
First Name:MARIA THERESA
Middle Name:
Last Name:ROGERS
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 MARTIN LUTHER KING JR AVE SW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-1131
Mailing Address - Country:US
Mailing Address - Phone:757-876-1846
Mailing Address - Fax:
Practice Address - Street 1:4601 MARTIN LUTHER KING JR AVE SW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-1131
Practice Address - Country:US
Practice Address - Phone:757-876-1846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDI100000873133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered