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Individual

ANTOINETTE BOGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
610 OLD YORK RD, JENKINTOWN, PA 19046-2837
(215) 820-3235
(844) 605-1833
Mailing address
610 OLD YORK ROAD, SUITE 400, JENKINTOWN, PA 19046-8406
(215) 820-3235

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
101YP2500X
Professional Counselor
PC014544
PA

Other

Enumeration date
03/14/2017
Last updated
07/09/2024
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