Individual
DR. LOLA C. BOGYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
277 STATE ST, SUITE 2A, BANGOR, ME 04401-5439
(207) 990-2580
(207) 990-1930
Mailing address
277 STATE ST, SUITE 2A, BANGOR, ME 04401-5439
(207) 990-2580
(207) 990-1930
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PS1251
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1689891384
ANTHEM
ME
Enumeration date
04/20/2007
Last updated
11/21/2016
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