Provider Demographics
NPI:1538406632
Name:RODGERS, JORI LEE
Entity type:Individual
Prefix:MISS
First Name:JORI
Middle Name:LEE
Last Name:RODGERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1476 SOUTH WEST POST OAK ROAD
Mailing Address - Street 2:
Mailing Address - City:INDIAHOMA
Mailing Address - State:OK
Mailing Address - Zip Code:73552
Mailing Address - Country:US
Mailing Address - Phone:580-215-2596
Mailing Address - Fax:
Practice Address - Street 1:1476 SOUTH WEST POST OAK ROAD
Practice Address - Street 2:
Practice Address - City:INDIAHOMA
Practice Address - State:OK
Practice Address - Zip Code:73552
Practice Address - Country:US
Practice Address - Phone:580-215-2596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor