Provider Demographics
NPI:1942095583
Name:ROGERS, JA'NIYA CHARRISH
Entity type:Individual
Prefix:
First Name:JA'NIYA
Middle Name:CHARRISH
Last Name:ROGERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2031 DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21217-3323
Mailing Address - Country:US
Mailing Address - Phone:443-876-6104
Mailing Address - Fax:
Practice Address - Street 1:7127 AMBASSADOR RD STE 150
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21244-3057
Practice Address - Country:US
Practice Address - Phone:667-406-0661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician