Individual
MRS. LINDA ANN BOGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2919 E 4TH ST, JOPLIN, MO 64801-1625
(417) 782-7966
(417) 624-4558
Mailing address
12114 DAVID LN, JOPLIN, MO 64804-8308
(417) 781-7768
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1215
MO
Other
Enumeration date
08/29/2013
Last updated
08/29/2013
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