Doctor Name: | CHRISTINE ELISE ROGOSKI |
NPI Number: | 1033440276 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 204 Hampton Dr # 3100 Venice, CA - 902912623 |
Business Phone Number: | 2079076043 |
Business Fax Number: | |
Mailing Address: | 204 Hampton Dr # 3100, VENICE |
State: | CA |
Postal Code: | 902912623 |
Phone Number: | 2079076043 |
Fax Number: | |
NPI Enumeration Date: | 01/28/2010 |
NPI Last Update Date: | 08/08/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |