Individual
KRISTEN ELIZABETH BOOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3521 BRIARFIELD BLVD, MAUMEE, OH 43537-9387
(419) 794-7259
(419) 794-7261
Mailing address
2222 CHERRY ST STE 1900, TOLEDO, OH 43608-2673
(419) 251-3878
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
P.08499
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0026196
—
OH
Enumeration date
02/09/2022
Last updated
04/14/2025
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