Provider Demographics
NPI:1568432839
Name:HOGGAN, KATHERINE MCENTIRE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:MCENTIRE
Last Name:HOGGAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1502 WILLOW LN
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84098-4509
Mailing Address - Country:US
Mailing Address - Phone:435-901-0286
Mailing Address - Fax:
Practice Address - Street 1:1750 SUN PEAK DR
Practice Address - Street 2:SUITE 175
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84098-6724
Practice Address - Country:US
Practice Address - Phone:435-901-0286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-26
Last Update Date:2012-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT49035046004101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT9979429OtherAETNA PROVIDER NUMBER
UT942938348H04OtherEDUCATORS MUTUAL