Provider Demographics
NPI:1922322965
Name:ROGERS, BRYNA E
Entity Type:Individual
Prefix:MRS
First Name:BRYNA
Middle Name:E
Last Name:ROGERS
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 1:13 TEMPLE ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-5110
Mailing Address - Country:US
Mailing Address - Phone:617-471-6400
Mailing Address - Fax:617-845-9257
Practice Address - Street 1:13 TEMPLE ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-5110
Practice Address - Country:US
Practice Address - Phone:617-471-6400
Practice Address - Fax:617-845-9257
Is Sole Proprietor?:No
Enumeration Date:2010-03-19
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health