Individual
CAMERON RODGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
21260 N. 1450 E., MORONI, UT 84646
(435) 851-0000
Mailing address
21260 N. 1450 E., MORONI, UT 84646
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000
—
UT
Enumeration date
04/22/2014
Last updated
04/22/2014
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