| NPI | 1447891221 |
|---|---|
| Other Name | JIMMY LEE ROGERS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MS 2433) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MS 2433) |
| 101YM0800X Counselor Mental Health (Licence: MS 2433) | |
| Enumeration Date | 2019-10-03 |
| Last Update Date | 2019-10-03 |