Doctor Name: | BRIAN ROGERS |
NPI Number: | 1013311893 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CCC-SLP |
License Number: | 14076771 |
Business Practice Address: | 17162 Coriander Ct Yorba Linda, CA - 928866248 |
Business Phone Number: | 7142005849 |
Business Fax Number: | |
Mailing Address: | 17162 Cariander Ct, YORBA LINDA |
State: | CA |
Postal Code: | 92886 |
Phone Number: | 7142005849 |
Fax Number: | |
NPI Enumeration Date: | 10/22/2014 |
NPI Last Update Date: | 10/22/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 14076771 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |