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NPI Code Detail

MEDICARE: DONNA ELLEN ROGG MSW

MEDICARE: DONNA ELLEN ROGG MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker002826CT

General Provider Information

NPI Number : 1639379241
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONNA ELLEN ROGG MSW
Provider Business Mailing Address
First Line : 127 KINGS HWY N
Second Line :
City : WESTPORT
State : CT
Zip : 06880-2422
Country : US
Telephone Number : 203-984-9014
Fax Number :
Provider Business Practice Location Address
First Line : 127 KINGS HWY N
Second Line :
City : WESTPORT
State : CT
Zip : 06880-2422
Country : US
Telephone Number : 203-984-9014
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2007
Last Update Date : 08/07/2016

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