Individual
KERREY BOGARDUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4225 E WINDROSE DR STE 300, PHOENIX, AZ 85032-7585
(480) 779-0727
Mailing address
1934 E SHEENA DR, PHOENIX, AZ 85022-4553
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY-T-000063
AZ
Other
Enumeration date
07/24/2024
Last updated
07/24/2024
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