Individual
AMANDA BOGERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
351 TENNY ST, BLOOMSBURG, PA 17815-3264
(570) 802-3099
Mailing address
PO BOX 428, BENTON, PA 17814-0428
(570) 535-0528
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/28/2021
Last updated
06/28/2021
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