Individual
ELLIE BOGGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22 N 1ST ST, NEWARK, OH 43055-5608
(740) 334-4056
Mailing address
22 N 1ST ST, NEWARK, OH 43055-5608
(740) 334-4056
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/28/2025
Last updated
05/28/2025
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