Provider Demographics
NPI:1134451909
Name:HOGAN, NORMA N (MA-CCC)
Entity type:Individual
Prefix:MS
First Name:NORMA
Middle Name:N
Last Name:HOGAN
Suffix:
Gender:F
Credentials:MA-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 DAVENTRY LN STE 100
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-2879
Mailing Address - Country:US
Mailing Address - Phone:502-423-0230
Mailing Address - Fax:502-423-0320
Practice Address - Street 1:105 DAVENTRY LN STE 100
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-2879
Practice Address - Country:US
Practice Address - Phone:502-423-0230
Practice Address - Fax:502-423-0320
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-04
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY93231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist