Individual
LORI ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
328 S WALNUT ST, GNADENHUTTEN, OH 44629-9754
(330) 407-2633
Mailing address
328 S WALNUT ST, GNADENHUTTEN, OH 44629-9754
(330) 407-2633
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/21/2019
Last updated
10/21/2019
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