| Doctor Name: | DR. MARIE THERESE ROGERS |
| NPI Number: | 1053521955 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | PY6312 |
| Business Practice Address: | 3650 N Federal Hwy Ste 215 Lighthouse Point, FL - 330646649 |
| Business Phone Number: | 9547826461 |
| Business Fax Number: | 9547828389 |
| Mailing Address: | 3650 N Federal Hwy Ste 215, LIGHTHOUSE POINT |
| State: | FL |
| Postal Code: | 330646649 |
| Phone Number: | 9547826461 |
| Fax Number: | 9547828389 |
| NPI Enumeration Date: | 05/22/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PY6312 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |