Doctor Name: | MR. RODGER BROOKS MOLES |
NPI Number: | 1043283088 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MS |
License Number: | 002823 |
Business Practice Address: | 1601 S Colby Ave Marshall, MO - 653403215 |
Business Phone Number: | 6608157105 |
Business Fax Number: | |
Mailing Address: | 1601 S Colby Ave, MARSHALL |
State: | MO |
Postal Code: | 653403215 |
Phone Number: | 6608315428 |
Fax Number: | |
NPI Enumeration Date: | 02/09/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 002823 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |