Provider Demographics
NPI:1659837839
Name:RODGERS, ERIN L
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:L
Last Name:RODGERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3630 GEORGE WASHINGTON MEM HWY STE D
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23693-3350
Mailing Address - Country:US
Mailing Address - Phone:757-690-9508
Mailing Address - Fax:
Practice Address - Street 1:3630 GEORGE WASHINGTON MEM HWY STE D
Practice Address - Street 2:
Practice Address - City:YORKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23693-3350
Practice Address - Country:US
Practice Address - Phone:757-690-9508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-13
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst