Provider Demographics
NPI:1407047855
Name:HOGAN, DEBORAH ELAINE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ELAINE
Last Name:HOGAN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:ELAINE
Other - Last Name:MCKENZIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:1537 AVENUE D
Mailing Address - Street 2:SUITE 111
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-3048
Mailing Address - Country:US
Mailing Address - Phone:406-252-9600
Mailing Address - Fax:406-657-9759
Practice Address - Street 1:1537 AVENUE D
Practice Address - Street 2:SUITE 111
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-3048
Practice Address - Country:US
Practice Address - Phone:406-252-9600
Practice Address - Fax:406-657-9759
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-09
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT3583235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist