MEDICARE: MS. MARTHA ELIZABETH ROGERS MS, CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	180 -154	WI

General Provider Information

NPI Number	:	1538429345
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARTHA ELIZABETH ROGERS MS, CCC-SLP

Provider Business Mailing Address
First Line	:	3333 N ARGONNE DR
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53222-3419
Country	:	US
Telephone Number	:	414-378-9804
Fax Number	:

Provider Business Practice Location Address
First Line	:	3333 N ARGONNE DR
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53222-3419
Country	:	US
Telephone Number	:	414-378-9804
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2012
Last Update Date	:	05/25/2012

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Directions to “ MS. MARTHA ELIZABETH ROGERS MS, CCC-SLP” Practice Location

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