Provider Demographics
NPI:1619705803
Name:ROGERS, KRISTI (APSW)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:
Last Name:ROGERS
Suffix:
Gender:F
Credentials:APSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N6528 ANDERSON DR
Mailing Address - Street 2:
Mailing Address - City:DELAVAN
Mailing Address - State:WI
Mailing Address - Zip Code:53115-2694
Mailing Address - Country:US
Mailing Address - Phone:262-566-8703
Mailing Address - Fax:
Practice Address - Street 1:3005 S RIVERSIDE DR STE 102
Practice Address - Street 2:
Practice Address - City:BELOIT
Practice Address - State:WI
Practice Address - Zip Code:53511-1500
Practice Address - Country:US
Practice Address - Phone:608-299-7669
Practice Address - Fax:608-621-5180
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker