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General NPI Number Information
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NPI Number | 1942980628
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Entity Type | Individual
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Provider Name | MEGAN RODGERS
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Gender | Female
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Dates
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Enumeration Date | 07/19/2023
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Last Update Date | 07/19/2023
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Provider Practice Location Address
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Address Line | 1130 BOONE AIRE RD
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City | FLORENCE
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State | KY
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Zip | 41042-1202
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Country | US
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Telephone | 859-282-6518
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Fax |
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Provider Business Mailing Address
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Address Line | 11490 US HIGHWAY 42
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City | UNION
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State | KY
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Zip | 41091-9483
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-22-246277
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License Number State | KY
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