Provider Demographics
NPI:1023792157
Name:HOGAN, RUTH CAROLINE (BCBA)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:CAROLINE
Last Name:HOGAN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:RUTH
Other - Middle Name:CAROLINE
Other - Last Name:WOODWARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4806 RIXIE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72117-1537
Mailing Address - Country:US
Mailing Address - Phone:501-500-2111
Mailing Address - Fax:501-244-9999
Practice Address - Street 1:4806 RIXIE RD
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-1537
Practice Address - Country:US
Practice Address - Phone:501-500-2111
Practice Address - Fax:501-244-9999
Is Sole Proprietor?:No
Enumeration Date:2023-06-09
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1-23-65895103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst