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Individual

JEFFREY RICHARD ROGERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BBH-ACLC-LIC 64043

Contact information

Practice address
913 SW HIGGINS AVE STE 201, MISSOULA, MT 59803-1423
(406) 540-4120
Mailing address
913 SW HIGGINS AVE STE 201, MISSOULA, MT 59803-1423
(406) 540-4120

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
BBH-ACLC-LIC-64043
MT

Other

Enumeration date
09/11/2023
Last updated
09/11/2023
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