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General NPI Number Information
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NPI Number | 1447828108
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Entity Type | Organization
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Legal Business Name | KELENE ROGERS, LLC
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Dates
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Enumeration Date | 06/17/2021
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Last Update Date | 06/17/2021
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Provider Practice Location Address
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Address Line | 4386 AUTUMN JOY ST
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City | GALESBURG
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State | MI
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Zip | 49053-7700
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Country | US
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Telephone | 269-806-2105
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 581
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City | RICHLAND
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State | MI
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Zip | 49083-0581
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROFESSIONAL COUNSELOR
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Name | MRS. KELENE ROGERS
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Credential | LPC
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Telephone | 269-806-2105
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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