Individual
MS. TRACI M HOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC
Contact information
Practice address
335 FOUR MILE RD, CONWAY, SC 29526-4506
(843) 488-6760
Mailing address
PO BOX 260005, CONWAY, SC 29528-6005
(843) 488-6760
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
03/01/2013
Last updated
03/01/2013
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