Doctor Name: | CYNTHIA BOGDANOFF |
NPI Number: | 1538561063 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | OU1001201 |
Business Practice Address: | 4836 State Route 325 Patriot, OH - 456588960 |
Business Phone Number: | 7403799085 |
Business Fax Number: | |
Mailing Address: | 4836 St. Rt. 325, Gallia County Schools PATRIOT |
State: | OH |
Postal Code: | 45658 |
Phone Number: | 7403799085 |
Fax Number: | |
NPI Enumeration Date: | 09/16/2014 |
NPI Last Update Date: | 09/16/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | OU1001201 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |