Provider Demographics
NPI:1902260953
Name:ROGERS, HANNAH (MT-BC)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:ROGERS
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 BIENVILLE ST
Mailing Address - Street 2:SUITE 9
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70607-5851
Mailing Address - Country:US
Mailing Address - Phone:337-425-6490
Mailing Address - Fax:
Practice Address - Street 1:620 BIENVILLE ST
Practice Address - Street 2:SUITE 9
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70607-5851
Practice Address - Country:US
Practice Address - Phone:337-425-6490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-06
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA17175225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist