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General NPI Number Information
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NPI Number | 1992326920
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Entity Type | Individual
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Provider Name | SARAJANE ELIZABETH RODGERS MS, MSC
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Gender | Female
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Dates
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Enumeration Date | 04/30/2020
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Last Update Date | 09/19/2023
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Provider Practice Location Address
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Address Line | 59 GENERAL WARREN BLVD STE 101
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City | MALVERN
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State | PA
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Zip | 19355-1245
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Country | US
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Telephone | 484-870-5608
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Fax |
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Provider Business Mailing Address
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Address Line | 5370 POND MOUNTAIN RD
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City | BROAD RUN
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State | VA
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Zip | 20137-2026
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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