Provider Demographics
NPI:1568586022
Name:BOGAY, CHRISTIE MONIQUE (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTIE
Middle Name:MONIQUE
Last Name:BOGAY
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5286 TRAILVIEW DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-4643
Mailing Address - Country:US
Mailing Address - Phone:314-355-0536
Mailing Address - Fax:
Practice Address - Street 1:3111 CORA AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63115-2304
Practice Address - Country:US
Practice Address - Phone:314-355-0536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003023199235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist