Provider Demographics
NPI:1811660541
Name:ROGERS, JANE B (PHD)
Entity type:Individual
Prefix:DR
First Name:JANE
Middle Name:B
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 1:112 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:WAYLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01778-4543
Mailing Address - Country:US
Mailing Address - Phone:508-416-0508
Mailing Address - Fax:
Practice Address - Street 1:185 BAY STATE RD
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-1584
Practice Address - Country:US
Practice Address - Phone:617-358-1426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-28
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist