Individual
TARA RODGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
777 E 15TH ST, APT. 112, EDMOND, OK 73013-5038
(918) 734-2951
Mailing address
777 E 15TH ST, APT. 112, EDMOND, OK 73013-5038
(918) 734-2951
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
11/24/2015
Last updated
12/17/2024
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