Provider Demographics
NPI:1104915271
Name:ROGERS, DENISE A (MA, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:DENISE
Middle Name:A
Last Name:ROGERS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5980 BREWSTER DR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-3912
Mailing Address - Country:US
Mailing Address - Phone:234-380-5642
Mailing Address - Fax:
Practice Address - Street 1:4200 INTERCHANGE CORPORATE CENTER RD
Practice Address - Street 2:
Practice Address - City:WARRENSVILLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44128-5631
Practice Address - Country:US
Practice Address - Phone:216-910-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP10426235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist