Provider Demographics
NPI:1134720774
Name:BOEGER, GABRIELLA HOPE (MS, LMFT)
Entity type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:HOPE
Last Name:BOEGER
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 BROADWAY BLVD APT 603
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64105-2096
Mailing Address - Country:US
Mailing Address - Phone:913-634-0777
Mailing Address - Fax:
Practice Address - Street 1:12351 W 96TH TER STE 108
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-4400
Practice Address - Country:US
Practice Address - Phone:913-491-6876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS03211106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist