Healthcare Provider Details

I. General information

NPI: 1114742228
Provider Name (Legal Business Name): MAGGIE ROGERS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2024
Last Update Date: 11/22/2024
Certification Date: 11/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3321 NAVAJO ST
DENVER CO
80211-3532
US

IV. Provider business mailing address

3321 NAVAJO ST
DENVER CO
80211-3532
US

V. Phone/Fax

Practice location:
  • Phone: 512-497-4770
  • Fax:
Mailing address:
  • Phone: 512-497-4770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MAGGIE ROGERS
Title or Position: OWNER
Credential:
Phone: 512-497-4770