Individual
DERRICK BOGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2309 W CONE BLVD STE 220, GREENSBORO, NC 27408-4047
(336) 491-5706
Mailing address
4720 CHESTERFIELD PL, JAMESTOWN, NC 27282-8656
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A20699
NC
Other
Enumeration date
12/19/2024
Last updated
12/19/2024
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