Individual
MRS. JENNIFER U BOGGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, CADC I
Contact information
Practice address
10 PIER 1 STE 203, ASTORIA, OR 97103
(503) 994-6394
(503) 386-2042
Mailing address
PO BOX 286, NASELLE, WA 98638-0286
(503) 994-6394
(503) 386-2042
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
08-08-05
OR
1041C0700X
Clinical Social Worker
Primary
L5767
OR
1041C0700X
Clinical Social Worker
LW 60297208
WA
Other
Enumeration date
08/20/2013
Last updated
02/04/2019
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