Healthcare Provider Details

I. General information

NPI: 1437476751
Provider Name (Legal Business Name): ASIA JANA ROGERS M.ED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2010
Last Update Date: 04/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1729 W 33RD ST STE B
EDMOND OK
73013-3836
US

IV. Provider business mailing address

2412 SW 103RD TER
OKLAHOMA CITY OK
73159-7518
US

V. Phone/Fax

Practice location:
  • Phone: 405-216-5608
  • Fax: 405-216-5272
Mailing address:
  • Phone: 405-703-1405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: