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General NPI Number Information
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NPI Number | 1568768547
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Entity Type | Individual
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Provider Name | SUSAN H. ROGERS L.M.S.W.
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Gender | Female
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Dates
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Enumeration Date | 02/08/2011
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Last Update Date | 02/08/2011
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Provider Practice Location Address
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Address Line | 210 E 3RD ST SUITE 210
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City | ROYAL OAK
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State | MI
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Zip | 48067-2638
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Country | US
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Telephone | 248-691-8500
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Fax | 248-246-2244
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Provider Business Mailing Address
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Address Line | 210 E 3RD ST SUITE 210
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City | ROYAL OAK
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State | MI
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Zip | 48067-2638
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Country | US
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Telephone | 248-691-8500
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Fax | 248-246-2244
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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 | 6801012881
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License Number State | MI
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