| Doctor Name: | DR. JASON D RODKER |
| NPI Number: | 1013305101 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSY.D. |
| License Number: | 143-050 |
| Business Practice Address: | 90 Millburn Ave Millburn, NJ - 070411945 |
| Business Phone Number: | 9733785525 |
| Business Fax Number: | 9733785590 |
| Mailing Address: | 90 Millburn Ave, MILLBURN |
| State: | NJ |
| Postal Code: | 070411945 |
| Phone Number: | 9733785525 |
| Fax Number: | 9733785590 |
| NPI Enumeration Date: | 12/26/2014 |
| NPI Last Update Date: | 12/26/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 143-050 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |