Healthcare Provider Details

I. General information

NPI: 1881122745
Provider Name (Legal Business Name): EMILY ELIZABETH ROGERS MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EMILY ELIZABETH BALL

II. Dates (important events)

Enumeration Date: 05/23/2017
Last Update Date: 03/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

721 N PINES RD STE 102
SPOKANE VALLEY WA
99206-5225
US

IV. Provider business mailing address

3124 W TRINITY PL
SPOKANE WA
99224-2224
US

V. Phone/Fax

Practice location:
  • Phone: 509-892-1100
  • Fax:
Mailing address:
  • Phone: 509-279-3368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: