Individual
DEIRDRE G. HOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
153 US ROUTE 1, SUITE 26, BOX 10, SCARBOROUGH, ME 04074-9052
(207) 329-9621
(207) 883-2721
Mailing address
153 US ROUTE 1, SUITE 26, BOX 10, SCARBOROUGH, ME 04074-9052
(207) 329-9621
(207) 883-2721
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LC6912
ME
1041C0700X
Clinical Social Worker
Primary
LC6912
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
431517499
—
ME
Enumeration date
10/04/2006
Last updated
01/28/2009
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