Jeremy Dale Rogers

Individual provider Active NPI Marriage & Family Therapist · Fort Smith, AR

NPI 1679917397 · NPPES record last updated Oct 19, 2018

Key facts

NPI
1679917397
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
Practice address
5306 Labelle CT
Fort Smith, AR 72903-2680
Phone
(191) 877-4530
NPI assigned
Apr 24, 2013
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Yes

Addresses

Primary practice location

5306 Labelle CT
Fort Smith, AR 72903-2680

Mailing address

2700 N 7TH St Apt 633
Broken Arrow, OK 74012-2583
Phone (191) 877-4530

Other providers in Fort Smith, AR

All providers in Fort Smith, AR · Marriage & Family Therapist in Arkansas

Sources for this page

Verify at the official NPI Registry.