Individual
JODI BETH RODGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
805 EARLY ST, SANTA FE, NM 87505-1607
(505) 955-0410
Mailing address
805 EARLY ST, SANTA FE, NM 87505-1607
(505) 955-0410
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
E7436
—
NM
Enumeration date
06/20/2013
Last updated
06/20/2013
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