Provider Demographics
NPI:1306529953
Name:ROGGERMEIER, SOPHIE EVA (CCC-SLP)
Entity type:Individual
Prefix:
First Name:SOPHIE
Middle Name:EVA
Last Name:ROGGERMEIER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 CAMPBELL ST APT 2SE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64109-1187
Mailing Address - Country:US
Mailing Address - Phone:404-618-7260
Mailing Address - Fax:
Practice Address - Street 1:2500 HIGH GROVE RD
Practice Address - Street 2:
Practice Address - City:GRANDVIEW
Practice Address - State:MO
Practice Address - Zip Code:64030-5400
Practice Address - Country:US
Practice Address - Phone:816-316-5500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023031281235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist