Provider Demographics
NPI:1790049534
Name:ROGERS, CHRISTIE LEE (MS, LPC CANDIDATE)
Entity Type:Individual
Prefix:MS
First Name:CHRISTIE
Middle Name:LEE
Last Name:ROGERS
Suffix:
Gender:F
Credentials:MS, LPC CANDIDATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:ALTUS
Mailing Address - State:OK
Mailing Address - Zip Code:73521-2118
Mailing Address - Country:US
Mailing Address - Phone:580-471-5643
Mailing Address - Fax:
Practice Address - Street 1:213 LAKESIDE DR
Practice Address - Street 2:
Practice Address - City:ALTUS
Practice Address - State:OK
Practice Address - Zip Code:73521-2118
Practice Address - Country:US
Practice Address - Phone:580-471-5643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-26
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health