Provider Demographics
NPI:1588799548
Name:HOGG, GREGORY ALFRED (LISW)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:ALFRED
Last Name:HOGG
Suffix:
Gender:M
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4531 READING RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-1215
Mailing Address - Country:US
Mailing Address - Phone:513-641-4300
Mailing Address - Fax:513-482-6922
Practice Address - Street 1:9819 DALY RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-2437
Practice Address - Country:US
Practice Address - Phone:513-641-4300
Practice Address - Fax:513-482-6922
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI. 00096581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical