Provider Demographics
NPI:1770979189
Name:ROGERS, DEANNA L (MSW)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:L
Last Name:ROGERS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 NW 1ST AVE APT 1207
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-3639
Mailing Address - Country:US
Mailing Address - Phone:401-855-0860
Mailing Address - Fax:
Practice Address - Street 1:1000 NW 1ST AVE APT 1207
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-3639
Practice Address - Country:US
Practice Address - Phone:401-855-0860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-13
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst