Individual
KERRIE BOGAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
431 WALTON PARK RD, MIDLOTHIAN, VA 23114-3032
(804) 437-2599
Mailing address
431 WALTON PARK RD, MIDLOTHIAN, VA 23114-3032
(804) 437-2599
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904006987
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4945255
—
VA
Enumeration date
02/02/2009
Last updated
09/15/2016
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