Provider Demographics
NPI:1780342220
Name:ROGERS, DAISY VALERIA (MA, BCBA)
Entity type:Individual
Prefix:
First Name:DAISY
Middle Name:VALERIA
Last Name:ROGERS
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22205 E 45TH AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80019-3620
Mailing Address - Country:US
Mailing Address - Phone:720-759-9957
Mailing Address - Fax:
Practice Address - Street 1:14704 E 2ND AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-3457
Practice Address - Country:US
Practice Address - Phone:720-206-9644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-01
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-21-55589103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst