Most Relevant Information
Provider Data
| NPI Number: | 1003415597 |
| Provider Name: | LORETTA ROGERS |
| Entity Type: | Individual |
| Taxonomy Code: | 175T00000X |
| Specialty: | Peer Specialist |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/26/2020 |
| Last Updated: | 10/26/2020 |
Provider Practice Location
102 PATRICK STREET PLZ
CHARLESTON
WV
253872444
Practice Location Phone/Fax
| Phone: | 3042333200 |
| Fax: |
Provider Mailing Location
102 PATRICK STREET PLZ
CHARLESTON
WV
253872444
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |