Healthcare Provider Details

I. General information

NPI: 1508793688
Provider Name (Legal Business Name): AMY ROGERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35465 125TH AVE
ONAMIA MN
56359-2944
US

IV. Provider business mailing address

35465 125TH AVE
ONAMIA MN
56359-2944
US

V. Phone/Fax

Practice location:
  • Phone: 320-532-6726
  • Fax:
Mailing address:
  • Phone: 320-532-4174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: