Provider Demographics
NPI:1689996795
Name:HOGG, ANNA DIONNE (MS, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:DIONNE
Last Name:HOGG
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8863 STATE ROUTE 163
Mailing Address - Street 2:
Mailing Address - City:MILLSTADT
Mailing Address - State:IL
Mailing Address - Zip Code:62260-3247
Mailing Address - Country:US
Mailing Address - Phone:618-704-5997
Mailing Address - Fax:
Practice Address - Street 1:8863 STATE ROUTE 163
Practice Address - Street 2:
Practice Address - City:MILLSTADT
Practice Address - State:IL
Practice Address - Zip Code:62260-3247
Practice Address - Country:US
Practice Address - Phone:618-704-5997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-17
Last Update Date:2023-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1-11-8058103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst