Individual
DR. JAN PARR BOGGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1508 37TH AVENUE, MERIDIAN, MS 39307
(601) 482-4285
(601) 482-7972
Mailing address
P O BOX 4093, MERIDIAN, MS 39304-4093
(601) 482-4285
(601) 482-7972
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
25-335
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00015202
—
MS
Enumeration date
05/02/2007
Last updated
07/08/2007
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