Individual
JESSICA BOGACZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2701 CHESTNUT STATION CT, LOUISVILLE, KY 40299-6395
(800) 335-1060
Mailing address
1488 MACKINAW PL, SCHERERVILLE, IN 46375-1289
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
07/27/2015
Last updated
07/27/2015
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