Individual
MRS. COLLEEN C. BOGNER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
1800 MARKET ST, LEWISBURG, PA 17837-1236
(570) 524-9477
(570) 524-9492
Mailing address
1 FAIRWAY DR, SELINSGROVE, PA 17870-9104
(570) 743-5511
(570) 524-9492
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW 015055
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50000159
CAPITAL BLUE CROSS
PA
Enumeration date
06/02/2006
Last updated
07/08/2007
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