Organization Name: | BOGARD FAMILY THERAPY & REHAB |
NPI Number: | 1740468446 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JENNIFER LYNN SPICELAND BOGARD (OWNER/SLP) |
Mailing Address: | 949 Hwy 79 Dover |
State: | TN US |
Postal Code: | 370580949 |
Phone Number: | 9312325200 |
Fax Number: | 9312321120 |
NPI Enumeration Date: | 02/05/2008 |
NPI Last Update Date: | 02/05/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 3070 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
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 |