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NPI 1972022952

NPI 1972022952 : MS. DEBRA MARY RODGERS : WAKEFIELD, RI

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General NPI Number Information
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    NPI Number           |    1972022952
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    Entity Type          |    Individual 
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    Provider Name        |    MS. DEBRA MARY RODGERS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/11/2017
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    Last Update Date     |    05/14/2025
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Provider Practice Location Address
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    Address Line         |    24 SALT POND RD STE H1 
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    City                 |    WAKEFIELD
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    State                |    RI
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    Zip                  |    02879-4337
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    Country              |    US
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    Telephone            |    401-789-3694
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    Fax                  |    401-789-3748
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Provider Business Mailing Address
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    Address Line         |    24 SALT POND RD SUITE H1 
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    City                 |    WAKEFIELD
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    State                |    RI
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    Zip                  |    02904-5762
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    Country              |    US
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    Telephone            |    401-789-3694
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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        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    MHC01102
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    License Number State |    RI
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