Doctor Name: | CHASITY TIMEKA BOGAY |
NPI Number: | 1730323700 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., CCC-SLP |
License Number: | 146.008402 |
Business Practice Address: | 2412 E Washington St Suite 8b Bloomington, IL - 617044497 |
Business Phone Number: | 3096634172 |
Business Fax Number: | |
Mailing Address: | 116 Hawthorne Lake Dr, BLOOMINGTON |
State: | IL |
Postal Code: | 617048530 |
Phone Number: | 3097068862 |
Fax Number: | |
NPI Enumeration Date: | 04/22/2009 |
NPI Last Update Date: | 04/22/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 146.008402 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |