Individual
NICOLE BOGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4935 HILLEGAS RD STE 200, FORT WAYNE, IN 46818-1943
(260) 338-1241
Mailing address
4935 HILLEGAS RD STE 200, FORT WAYNE, IN 46818-1943
(260) 338-1241
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22007951A
IN
Other
Enumeration date
07/18/2022
Last updated
07/18/2022
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