| Doctor Name: | DR. THOMAS EDWARD RODGERSON |
| NPI Number: | 1346248580 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | LC0154 |
| Business Practice Address: | 8203 Harford Rd Parkville, MD - 212345888 |
| Business Phone Number: | 4108821988 |
| Business Fax Number: | 4108821898 |
| Mailing Address: | 14616 Jaystone Dr, SILVER SPRING |
| State: | MD |
| Postal Code: | 209057405 |
| Phone Number: | 3013882535 |
| Fax Number: | 3013882536 |
| NPI Enumeration Date: | 07/12/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LC0154 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |