Individual
PATRICIA BOGRETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED, LBS, BCBA
Contact information
Practice address
125 SCHNEIDER DR, LEBANON, PA 17046-4875
(717) 270-2444
(717) 270-2472
Mailing address
23 N LINGLE AVE, HERSHEY, PA 17033-1144
(717) 648-0530
(717) 709-6529
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH001883
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12700712
CAQH ID #
—
01
—
BH001883
STATE LICENSE
PA
Enumeration date
10/30/2019
Last updated
10/17/2023
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