Provider Demographics
NPI:1619968138
Name:ROGERS, RHONDA L (PHD)
Entity Type:Individual
Prefix:DR
First Name:RHONDA
Middle Name:L
Last Name:ROGERS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 CREEKVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021-3709
Mailing Address - Country:US
Mailing Address - Phone:478-697-7836
Mailing Address - Fax:
Practice Address - Street 1:122 CREEKVIEW CIR
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-3709
Practice Address - Country:US
Practice Address - Phone:478-697-7836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE692103TC0700X
GAPSY004320103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical