Individual
MR. RANDALL JOEL ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
6124 N 99TH ST, OMAHA, NE 68134-1548
(402) 884-0716
Mailing address
PO BOX 31182, OMAHA, NE 68131-0182
(402) 573-1142
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
9808
NE
Other
Enumeration date
10/20/2012
Last updated
10/20/2012
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