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General NPI Number Information
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NPI Number | 1245455294
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Entity Type | Individual
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Provider Name | TEMIKA ROGERS LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 03/12/2019
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Provider Practice Location Address
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Address Line | 813 W 6TH AVE
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City | PINE BLUFF
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State | AR
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Zip | 71601-4031
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Country | US
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Telephone | 870-568-4502
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Fax | 870-395-7086
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Provider Business Mailing Address
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Address Line | PO BOX 1926
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City | PINE BLUFF
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State | AR
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Zip | 71613-1926
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Country | US
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Telephone | 870-718-2349
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Fax | 870-395-7086
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 5469-C
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License Number State | AR
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