Provider Demographics
NPI:1679009047
Name:RODGERS, ALLISON (RBT)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:RODGERS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:GULD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5904 CANCUN AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-3921
Mailing Address - Country:US
Mailing Address - Phone:702-715-7208
Mailing Address - Fax:
Practice Address - Street 1:5940 S RAINBOW BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-2506
Practice Address - Country:US
Practice Address - Phone:888-531-8385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-04
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator