Provider Demographics
NPI:1336291905
Name:HOGAN, DEBORAH S
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:S
Last Name:HOGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:DEBORAH
Other - Middle Name:S
Other - Last Name:HOGAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:1012 JACKSON RD
Mailing Address - Street 2:
Mailing Address - City:PARK HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41011-1912
Mailing Address - Country:US
Mailing Address - Phone:859-491-8044
Mailing Address - Fax:859-491-8044
Practice Address - Street 1:1012 JACKSON RD
Practice Address - Street 2:
Practice Address - City:PARK HILLS
Practice Address - State:KY
Practice Address - Zip Code:41011-1912
Practice Address - Country:US
Practice Address - Phone:859-491-8044
Practice Address - Fax:859-491-8044
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY157S235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist