| Doctor Name: | MISS CONSUELA NMN ROGERS |
| NPI Number: | 1053496695 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW, CCS, LCAS, LCSW |
| License Number: | 815 |
| Business Practice Address: | 2817 Reilly St Troop Medical Clinic Stop G Mcxc Fort Bragg, NC - 283107324 |
| Business Phone Number: | 9109078925 |
| Business Fax Number: | |
| Mailing Address: | 2817 Reilly St, Troop Medical Clinic Stop G Mcxc FORT BRAGG |
| State: | NC |
| Postal Code: | 283107324 |
| Phone Number: | 9109078925 |
| Fax Number: | |
| NPI Enumeration Date: | 10/25/2006 |
| NPI Last Update Date: | 08/15/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 815 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |