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NPI Code Detail

MEDICARE: CHERYL LYNN ROGERS PHD, CCC-SLP

MEDICARE: CHERYL LYNN ROGERS PHD, CCC-SLP
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
1235Z00000XSpeech-Language Pathologist2390SC

General Provider Information

NPI Number : 1740207729
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHERYL LYNN ROGERS PHD, CCC-SLP
Provider Business Mailing Address
First Line : 1601 SAINT JULIAN PL
Second Line :
City : COLUMBIA
State : SC
Zip : 29204-2407
Country : US
Telephone Number : 803-777-2614
Fax Number :
Provider Business Practice Location Address
First Line : 1601 SAINT JULIAN PL
Second Line :
City : COLUMBIA
State : SC
Zip : 29204-2407
Country : US
Telephone Number : 803-777-2614
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2006
Last Update Date : 07/08/2007

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