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Individual

DR. JEFFREY T BOGGESS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
1115 20TH STREET, SUITE 205, HUNTINGTON, WV 25703
(304) 691-1500
(304) 691-1510
Mailing address
1115 20TH STREET, SUITE 205, HUNTINGTON, WV 25703
(304) 691-1500
(304) 691-1510

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
544
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0163845000
WV
01
544
LICENSE OF PSYCHOLOGY
WV
Enumeration date
07/07/2006
Last updated
07/18/2013
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