Provider Demographics
NPI:1518411438
Name:HOGG, BETH ANN (SLP)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:ANN
Last Name:HOGG
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 WALLINGTON WAY
Mailing Address - Street 2:STE 103
Mailing Address - City:MARRIOTTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21104-1505
Mailing Address - Country:US
Mailing Address - Phone:410-442-9791
Mailing Address - Fax:410-442-9783
Practice Address - Street 1:2500 WALLINGTON WAY
Practice Address - Street 2:STE 103
Practice Address - City:MARRIOTTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21104-1505
Practice Address - Country:US
Practice Address - Phone:410-442-9791
Practice Address - Fax:410-442-9783
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-09
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.008485235Z00000X
MD08312235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist