Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003415332 |
---|---|
Provider Name | Margaret Rodgers |
First Address | Enterprise, OR 97828-0268 |
Second Address | Enterprise, OR 97828-6011 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2020 |
Last Update Date | 19/10/2020 |