Individual
MRS. ROBERTA J BOGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
110 YE OLDE KINGS HWY, NORTH MYRTLE BEACH, SC 29582-3050
(843) 663-0770
(843) 663-0772
Mailing address
110 YE OLDE KINGS HWY, NORTH MYRTLE BEACH, SC 29582-3050
(843) 663-0770
(843) 663-0772
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
E0008241
OH
101YM0800X
Mental Health Counselor
Primary
5005
SC
Other
Enumeration date
10/27/2006
Last updated
11/20/2011
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