Provider Demographics
NPI:1003477860
Name:ROGERS, JANICE MICHELE
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:MICHELE
Last Name:ROGERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:MICHELE
Other - Last Name:HANFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20 CROCUS CT
Mailing Address - Street 2:
Mailing Address - City:CONOWINGO
Mailing Address - State:MD
Mailing Address - Zip Code:21918-1700
Mailing Address - Country:US
Mailing Address - Phone:443-485-8569
Mailing Address - Fax:
Practice Address - Street 1:307 INTERNATIONAL CIR STE 100
Practice Address - Street 2:
Practice Address - City:COCKEYSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21030-1387
Practice Address - Country:US
Practice Address - Phone:864-244-3626
Practice Address - Fax:864-244-6923
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist