Provider Demographics
NPI:1942215827
Name:ROGISTER, STEPHANIE HARDER (MS-CCC)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:HARDER
Last Name:ROGISTER
Suffix:
Gender:F
Credentials:MS-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 DELLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6717
Mailing Address - Country:US
Mailing Address - Phone:919-781-0107
Mailing Address - Fax:530-733-3630
Practice Address - Street 1:1408 DELLWOOD DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6717
Practice Address - Country:US
Practice Address - Phone:919-781-0107
Practice Address - Fax:530-733-3630
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC407235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC02583OtherBCBS GROUP NUMBER
NC72991OtherBCBS PROVIDER NO.