Individual
AUDREY KATHERINE BOGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
505 S JOHN REDDITT DR, LUFKIN, TX 75904-3120
(214) 476-8547
Mailing address
505 S JOHN REDDITT DR, LUFKIN, TX 75904-3120
(214) 476-8547
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT84911
TX
Other
Enumeration date
09/09/2019
Last updated
09/09/2019
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