Provider Demographics
NPI:1164167292
Name:ROGERS, EMILY (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:ROGERS
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 MARYLAND AVE
Mailing Address - Street 2:
Mailing Address - City:NUTTER FORT
Mailing Address - State:WV
Mailing Address - Zip Code:26301-4446
Mailing Address - Country:US
Mailing Address - Phone:304-677-9308
Mailing Address - Fax:
Practice Address - Street 1:909 GORMAN AVE STE 6
Practice Address - Street 2:
Practice Address - City:ELKINS
Practice Address - State:WV
Practice Address - Zip Code:26241-3100
Practice Address - Country:US
Practice Address - Phone:304-637-3630
Practice Address - Fax:304-637-5606
Is Sole Proprietor?:No
Enumeration Date:2022-05-03
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2054225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation