Provider Demographics
NPI:1215766738
Name:RODGERS, MIKYLA (SLP-CF)
Entity type:Individual
Prefix:
First Name:MIKYLA
Middle Name:
Last Name:RODGERS
Suffix:
Gender:F
Credentials:SLP-CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4751 W BRADDOCK RD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311-4751
Mailing Address - Country:US
Mailing Address - Phone:631-432-2263
Mailing Address - Fax:
Practice Address - Street 1:5800 8TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-1902
Practice Address - Country:US
Practice Address - Phone:202-291-7499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-01
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist