Provider Demographics
NPI:1114100138
Name:HARRISON-RODGERS, DEBOARH ANN (AS)
Entity Type:Individual
Prefix:MS
First Name:DEBOARH
Middle Name:ANN
Last Name:HARRISON-RODGERS
Suffix:
Gender:F
Credentials:AS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1099 SYLMAR AVE
Mailing Address - Street 2:106
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-1661
Mailing Address - Country:US
Mailing Address - Phone:559-324-0743
Mailing Address - Fax:
Practice Address - Street 1:611 E BELMONT AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93701-1502
Practice Address - Country:US
Practice Address - Phone:559-237-3420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-12
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)