| Doctor Name: | THOMAS E RODGERS |
| NPI Number: | 1306148259 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MA, NCC, LPC, CADC1 |
| License Number: | 11-06-64 |
| Business Practice Address: | 2100 Main St Baker City, OR - 978142655 |
| Business Phone Number: | 5415233646 |
| Business Fax Number: | 5415237602 |
| Mailing Address: | 2100 Main St, P.o. Box 1005 BAKER CITY |
| State: | OR |
| Postal Code: | 978142655 |
| Phone Number: | 5415233646 |
| Fax Number: | 5415237602 |
| NPI Enumeration Date: | 11/29/2010 |
| NPI Last Update Date: | 01/28/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 11-06-64 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |