Provider Demographics
NPI:1821656570
Name:WNOROWSKI-BOGLE, MEGHAN (LPAT, ATR-BC)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:WNOROWSKI-BOGLE
Suffix:
Gender:F
Credentials:LPAT, ATR-BC
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:
Other - Last Name:WNOROWSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPAT, ATR-BC
Mailing Address - Street 1:408 CORNELL PL
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-2932
Mailing Address - Country:US
Mailing Address - Phone:502-558-5651
Mailing Address - Fax:
Practice Address - Street 1:408 CORNELL PL
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-2932
Practice Address - Country:US
Practice Address - Phone:502-558-5651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-29
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY172747221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist