Individual
MR. RUSSELL WILLIAM HOGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MED,CAC,LPC,CCDP
Contact information
Practice address
3030 CHESTNUT ST., LEBANON TREATMENT CENTER, LEBANON, PA 17042
(717) 273-8000
(717) 273-8244
Mailing address
21 PINEWOOD AVE., LITITZ, PA 17543
(717) 626-6811
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
PC000649
PA
Other
Enumeration date
09/03/2008
Last updated
09/03/2008
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