Individual
KENNETH CHARLES ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.D.
Contact information
Practice address
425 HARVARD ST, DORCHESTER, MA 02124-2737
(617) 740-0109
(617) 740-0110
Mailing address
294 BLUE HILL AVE, MILTON, MA 02186-1015
(617) 291-6927
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
2818
MA
Other
Enumeration date
04/25/2018
Last updated
04/25/2018
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