Provider Demographics
NPI:1952982837
Name:HOGANCAMP, DONNA
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:HOGANCAMP
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 1:225 S SMITH RD
Mailing Address - Street 2:
Mailing Address - City:LAGRANGEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12540-5308
Mailing Address - Country:US
Mailing Address - Phone:845-677-4085
Mailing Address - Fax:
Practice Address - Street 1:6423 ROUTE 55
Practice Address - Street 2:
Practice Address - City:WINGDALE
Practice Address - State:NY
Practice Address - Zip Code:12594-1501
Practice Address - Country:US
Practice Address - Phone:845-350-3010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-21
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002079106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist