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Individual

MARK ALLEN HOGUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PSY.D.

Contact information

Practice address
120 E 2ND ST, THIRD FLOOR, ERIE, PA 16507-1537
(814) 452-8300
(814) 452-8308
Mailing address
120 E 2ND ST, THIRD FLOOR, ERIE, PA 16507-1537
(814) 452-8300
(814) 452-8308

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PS-004347-L
PA
103TC0700X
Clinical Psychologist
PS-004347-L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
620006097
RAILROAD MEDICARE IND#
PA
05
7368785
PA
Enumeration date
06/21/2005
Last updated
08/19/2015
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