Individual
KIMBERLEY BLYTHE HOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
625 NORTH MICHIGAN AVE, SUITE 1715, CHICAGO, IL 60611
(312) 751-0905
Mailing address
625 NORTH MICHIGAN AVE, SUITE 1715, CHICAGO, IL 60611
(312) 751-0905
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
071-006459
IL
Other
Enumeration date
12/22/2011
Last updated
12/22/2011
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