Individual
CHARISSA BOGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
154 W SPRINGBROOK DR, JOHNSON CITY, TN 37604-1758
(423) 926-1171
Mailing address
301 CAMBRIDGESHIRE CT, JOHNSON CITY, TN 37615-4683
(931) 249-5138
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
9891
TN
1041C0700X
Clinical Social Worker
Primary
8177
TN
Other
Enumeration date
04/29/2014
Last updated
03/18/2024
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