Provider Demographics
NPI:1649485905
Name:RODGERS, CHERYL LYNN (MRC, CRC, CCM)
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:LYNN
Last Name:RODGERS
Suffix:
Gender:F
Credentials:MRC, CRC, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2325 MONROE CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-9549
Mailing Address - Country:US
Mailing Address - Phone:937-339-4350
Mailing Address - Fax:937-339-6280
Practice Address - Street 1:2325 MONROE CONCORD RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-9549
Practice Address - Country:US
Practice Address - Phone:937-339-4350
Practice Address - Fax:937-339-6280
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH171M0000X171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator