Individual
DR. CARLY J RODGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
205 OCEAN AVE, PORTLAND, ME 04103-5712
(207) 554-7906
(207) 773-5512
Mailing address
205 OCEAN AVE, PORTLAND, ME 04103-5712
(207) 554-7906
(207) 773-5512
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS1555
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103850000
MAINE CARE
ME
Enumeration date
12/13/2007
Last updated
02/19/2020
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