Provider Demographics
NPI:1487228458
Name:BOGITS, ABIGAIL SANDRA
Entity Type:Individual
Prefix:MISS
First Name:ABIGAIL
Middle Name:SANDRA
Last Name:BOGITS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 E STATE ST UNIT 503
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-4386
Mailing Address - Country:US
Mailing Address - Phone:734-355-7964
Mailing Address - Fax:
Practice Address - Street 1:265 E STATE ST UNIT 503
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-4386
Practice Address - Country:US
Practice Address - Phone:734-355-7964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-14
Last Update Date:2024-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health