Provider Demographics
NPI:1780352385
Name:ROGERS, JODIE M (CHHC)
Entity type:Individual
Prefix:
First Name:JODIE
Middle Name:M
Last Name:ROGERS
Suffix:
Gender:F
Credentials:CHHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1819 LENO RD
Mailing Address - Street 2:
Mailing Address - City:MACEDON
Mailing Address - State:NY
Mailing Address - Zip Code:14502-9711
Mailing Address - Country:US
Mailing Address - Phone:585-775-9621
Mailing Address - Fax:
Practice Address - Street 1:1819 LENO RD
Practice Address - Street 2:
Practice Address - City:MACEDON
Practice Address - State:NY
Practice Address - Zip Code:14502-9711
Practice Address - Country:US
Practice Address - Phone:585-775-9621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-31
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach