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NPI Code Detail

MEDICARE: PHILINE RODGERS

MEDICARE:   PHILINE  RODGERS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TM1800XIntellectual & Developmental Disabilities Psychologist

General Provider Information

NPI Number : 1609684638
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHILINE RODGERS
Provider Business Mailing Address
First Line : 1512 MANSS AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45205-1053
Country : US
Telephone Number : 513-488-7586
Fax Number :
Provider Business Practice Location Address
First Line : 1512 MANSS AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45205-1053
Country : US
Telephone Number : 513-488-7586
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2024
Last Update Date : 01/04/2025

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Directions to “ PHILINE RODGERS ” Practice Location

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