Individual
ROGER SCHRADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
52 ADAMS ST APT 6, WALTHAM, MA 02453-4455
(917) 325-3669
Mailing address
52 ADAMS ST APT 6, WALTHAM, MA 02453-4455
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
124440
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
124440
ASWB
MA
Enumeration date
12/21/2021
Last updated
12/21/2021
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