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General NPI Number Information
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NPI Number | 1033928932
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Entity Type | Individual
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Provider Name | SAMANTHA FAYE ROGERS PSY.D, LP
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Gender | Female
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Dates
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Enumeration Date | 01/06/2025
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 200 3RD AVE NE
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City | CAMBRIDGE
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State | MN
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Zip | 55008-1299
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Country | US
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Telephone | 320-629-7600
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Fax |
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Provider Business Mailing Address
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Address Line | 19250 STATE HIGHWAY 95
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City | PRINCETON
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State | MN
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Zip | 55371-8420
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Country | US
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Telephone | 612-360-0887
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | LP7148
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License Number State | MN
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