Provider Demographics
NPI:1295057586
Name:ROGERS, JULIETTE MARY (MSCCC-SLP)
Entity type:Individual
Prefix:MS
First Name:JULIETTE
Middle Name:MARY
Last Name:ROGERS
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:MS
Other - First Name:JULIETTE
Other - Middle Name:MARY
Other - Last Name:ROGERS-OBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSCCC-SLP
Mailing Address - Street 1:3749 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:LUMBERVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18933-9715
Mailing Address - Country:US
Mailing Address - Phone:215-297-5869
Mailing Address - Fax:
Practice Address - Street 1:3749 RIVER RD
Practice Address - Street 2:
Practice Address - City:LUMBERVILLE
Practice Address - State:PA
Practice Address - Zip Code:18933-9715
Practice Address - Country:US
Practice Address - Phone:215-297-5869
Practice Address - Fax:215-297-5869
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-27
Last Update Date:2010-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL004738L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist