Individual
COURTNEY ELISABETH HOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
453 CARTER 154, FREMONT, MO 63941
(573) 776-0832
Mailing address
435 CARTER 154, FREMONT, MO 63941-8717
(573) 776-0832
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2020006859
MO
Other
Enumeration date
12/28/2020
Last updated
12/28/2020
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