Provider Demographics
NPI:1902011695
Name:OGLE, KEVIN L (DMIN, AAPC FELLOW)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:L
Last Name:OGLE
Suffix:
Gender:M
Credentials:DMIN, AAPC FELLOW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 BUXTON RD
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-3619
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1305 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-2238
Practice Address - Country:US
Practice Address - Phone:703-903-9696
Practice Address - Fax:703-821-2505
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral