Provider Demographics
NPI:1487042115
Name:HOGAN, AMY (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:HOGAN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 QUEEN ANNE CT
Mailing Address - Street 2:
Mailing Address - City:OCEAN VIEW
Mailing Address - State:NJ
Mailing Address - Zip Code:08230-2300
Mailing Address - Country:US
Mailing Address - Phone:267-815-1636
Mailing Address - Fax:
Practice Address - Street 1:24 QUEEN ANNE CT
Practice Address - Street 2:
Practice Address - City:OCEAN VIEW
Practice Address - State:NJ
Practice Address - Zip Code:08230-2300
Practice Address - Country:US
Practice Address - Phone:267-815-1636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-05
Last Update Date:2023-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst