MEDICARE: MARRIKA 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
1	101YM0800X	Mental Health Counselor	2051-226	WI

General Provider Information

NPI Number	:	1831514884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARRIKA RODGERS

Provider Business Mailing Address
First Line	:	5911 N LOVERS LANE RD
Second Line	:	106
City	:	MILWAUKEE
State	:	WI
Zip	:	53225-2250
Country	:	US
Telephone Number	:	414-803-2611
Fax Number	:

Provider Business Practice Location Address
First Line	:	5911 N LOVERS LANE RD
Second Line	:	106
City	:	MILWAUKEE
State	:	WI
Zip	:	53225-2250
Country	:	US
Telephone Number	:	414-803-2611
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2014
Last Update Date	:	02/27/2014

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Directions to “ MARRIKA RODGERS ” Practice Location

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