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Individual

ROBERTA L ROGERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
470 MANCHESTER AVE, YOUNGSTOWN, OH 44509-1709
(330) 979-1681
Mailing address
470 MANCHESTER AVE, YOUNGSTOWN, OH 44509-1709
(330) 979-1681

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
7801847
OH
374U00000X
Home Health Aide
7801847
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7801847
OH
Enumeration date
03/22/2018
Last updated
10/09/2021
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