Doctor Name: | DR. MATTHEW W ROGERS |
NPI Number: | 1134331242 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSYD |
License Number: | 6894 |
Business Practice Address: | 12611 Eckel Junction Rd Perrysburg, OH - 435511304 |
Business Phone Number: | 4198736326 |
Business Fax Number: | 4198736327 |
Mailing Address: | 3281 Sterlingwood Ln, PERRYSBURG |
State: | OH |
Postal Code: | 435513133 |
Phone Number: | 4196548899 |
Fax Number: | |
NPI Enumeration Date: | 05/03/2007 |
NPI Last Update Date: | 12/02/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 6894 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |