Healthcare Provider Details

I. General information

NPI: 1174514301
Provider Name (Legal Business Name): CHARLOTTE M. ROGERS L.P.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/05/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 QUINCY ST NE
WASHINGTON DC
20017-2615
US

IV. Provider business mailing address

20508 BARGENE WAY
GERMANTOWN MD
20874-1157
US

V. Phone/Fax

Practice location:
  • Phone: 202-526-4445
  • Fax:
Mailing address:
  • Phone: 301-972-3651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License NumberPRC1352
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: