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THOMAS FRAISER RODGER LPC
Professional >> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1124386180
Individual Registrant: THOMAS FRAISER RODGER LPC
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
123 VAN WERT ST. BUCHANAN, GA 30113 US
Tel: 770-646-6806 Fax: 770-646-6809
Tel: 770-646-6806 Fax: 770-646-6809
Contact information for business:
PO BOX 405 BUCHANAN, GA 30113-0405 US
Tel: 770-646-6806 Fax: 770-646-6809
Tel: 770-646-6806 Fax: 770-646-6809
Registration Information:
NPI: 1124386180
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 101YP2500X | Behavioral Health & Social Service Providers Counselor Professional |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
