Healthcare Provider Details

I. General information

NPI: 1225572191
Provider Name (Legal Business Name): CHRISTI ROGERS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2016
Last Update Date: 12/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9809 N HIGHWAY 171
GODLEY TX
76044-3443
US

IV. Provider business mailing address

9809 N HIGHWAY 171
GODLEY TX
76044-3443
US

V. Phone/Fax

Practice location:
  • Phone: 817-229-9235
  • Fax: 817-389-3589
Mailing address:
  • Phone: 817-229-9235
  • Fax: 817-389-3589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number71185
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: