Provider Demographics
NPI:1710422910
Name:HOGAN, DEVONDA (MHS)
Entity Type:Individual
Prefix:
First Name:DEVONDA
Middle Name:
Last Name:HOGAN
Suffix:
Gender:F
Credentials:MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 WHITNEY AVE
Mailing Address - Street 2:APT. D
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70114-1342
Mailing Address - Country:US
Mailing Address - Phone:504-563-9507
Mailing Address - Fax:
Practice Address - Street 1:4480 GENERAL DEGAULLE DR
Practice Address - Street 2:210
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70131-6941
Practice Address - Country:US
Practice Address - Phone:504-209-9161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-23
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator