Individual
RICO MONTINEZE HOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
BUILDING 327, CENTRAL HOSPITAL RD., FORT EISENHOWER, GA 30905
(706) 787-8651
Mailing address
2303 MURA DR, AUGUSTA, GA 30906-4819
(706) 589-2883
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C016133
NC
Other
Enumeration date
01/04/2024
Last updated
01/04/2024
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