Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003279530 |
---|---|
Provider Name | Monica Hogan |
First Address | Eugene, OR 97401-3541 |
Second Address | Eugene, OR 97401-3541 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2016 |
Last Update Date | 01/04/2016 |