Provider Demographics
NPI:1821670571
Name:HOGANS, MALCOLM (MS)
Entity Type:Individual
Prefix:
First Name:MALCOLM
Middle Name:
Last Name:HOGANS
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10525 NW 1ST ST
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:FL
Mailing Address - Zip Code:32321-3209
Mailing Address - Country:US
Mailing Address - Phone:850-815-0870
Mailing Address - Fax:
Practice Address - Street 1:10525 NW 1ST ST
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:FL
Practice Address - Zip Code:32321-3209
Practice Address - Country:US
Practice Address - Phone:850-815-0870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health