Provider Demographics
NPI:1831898816
Name:ROGERS, SAVANNA (MS, CFY-SLP)
Entity type:Individual
Prefix:
First Name:SAVANNA
Middle Name:
Last Name:ROGERS
Suffix:
Gender:F
Credentials:MS, CFY-SLP
Other - Prefix:
Other - First Name:SAVANNA
Other - Middle Name:
Other - Last Name:DOVERR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SAVANNA DOVER
Mailing Address - Street 1:606 EDGEMORE RD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-1153
Mailing Address - Country:US
Mailing Address - Phone:678-577-2088
Mailing Address - Fax:
Practice Address - Street 1:606 EDGEMORE RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-1153
Practice Address - Country:US
Practice Address - Phone:678-577-2088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-28
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
GAPCET003779235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAPCET003779OtherSTATE LICENSE