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Individual

JENNIFER BOGNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
480 W. 9TH AVENUE, DODD HALL, COLUMBUS, OH 43210
(614) 293-3830
(614) 293-4870
Mailing address
200 BRADENTON AVE, DUBLIN, OH 43017-7515
(614) 793-1980

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
4331
OH
103T00000X
Psychologist
4331
OH
103TR0400X
Rehabilitation Psychologist
Primary
4331
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0843323
OH
Enumeration date
08/08/2006
Last updated
04/15/2015
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