Provider Demographics
NPI:1952152456
Name:BOGAERTS, EVA FRANK
Entity Type:Individual
Prefix:MS
First Name:EVA
Middle Name:FRANK
Last Name:BOGAERTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 SHEATH DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212-2211
Mailing Address - Country:US
Mailing Address - Phone:803-800-6373
Mailing Address - Fax:
Practice Address - Street 1:108 SHEATH DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29212-2211
Practice Address - Country:US
Practice Address - Phone:803-800-6373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician