Provider Demographics
NPI:1225798531
Name:HOGG, KATHERINE MAE (LMT)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MAE
Last Name:HOGG
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1714 HANOVER AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-3506
Mailing Address - Country:US
Mailing Address - Phone:757-570-0607
Mailing Address - Fax:
Practice Address - Street 1:1714 HANOVER AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23220-3506
Practice Address - Country:US
Practice Address - Phone:757-570-0607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019016722225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist