Provider Demographics
NPI:1841404258
Name:ROGERS-DOLL, ELIZABETH SCOTT (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:SCOTT
Last Name:ROGERS-DOLL
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 1:40 CAMELOT DR
Mailing Address - Street 2:
Mailing Address - City:FOND DU LAC
Mailing Address - State:WI
Mailing Address - Zip Code:54935-8049
Mailing Address - Country:US
Mailing Address - Phone:920-907-8201
Mailing Address - Fax:920-907-8209
Practice Address - Street 1:40 CAMELOT DR
Practice Address - Street 2:
Practice Address - City:FOND DU LAC
Practice Address - State:WI
Practice Address - Zip Code:54935-8049
Practice Address - Country:US
Practice Address - Phone:920-907-8201
Practice Address - Fax:920-907-8209
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1701-57103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist