Individual
KELLY BOGGIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
2110 PRIEST BRIDGE DR STE 10, CROFTON, MD 21114-2653
(443) 223-9014
Mailing address
434 MCBRIDE LN, SEVERNA PARK, MD 21146-2822
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
22978
MD
Other
Enumeration date
05/20/2019
Last updated
03/10/2020
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