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General NPI Number Information
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NPI Number | 1447401674
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Entity Type | Organization
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Legal Business Name | STEVEN D. ROGERS, PH.D. P.C.
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Dates
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Enumeration Date | 10/07/2008
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Last Update Date | 10/07/2008
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Provider Practice Location Address
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Address Line | 1760 CENTURY BLVD NE STE B
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City | ATLANTA
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State | GA
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Zip | 30345-3310
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Country | US
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Telephone | 404-248-8032
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Fax |
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Provider Business Mailing Address
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Address Line | 1291 JODY LN NE
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City | ATLANTA
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State | GA
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Zip | 30329-3519
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Country | US
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Telephone | 404-216-3491
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. STEVEN D. ROGERS
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Credential | PH.D.
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Telephone | 404-216-3491
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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 | PSY1750
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License Number State | GA
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