Individual
HAILEY RODGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPRS
Contact information
Practice address
2408 SUSANNAH ST STE 1, JOHNSON CITY, TN 37601-1765
(423) 434-6677
(423) 461-0000
Mailing address
504 BEECHWOOD DR, KINGSPORT, TN 37663-2455
(423) 767-0830
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
1234
TN
175T00000X
Peer Specialist
Primary
1234
TN
Other
Enumeration date
06/25/2020
Last updated
06/25/2020
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