Individual
JORDAN BOGGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
851 PROFESSIONAL PARK DR, CLARKSVILLE, TN 37040-5257
(931) 542-2168
Mailing address
405 ADAMS MILL RD, CADIZ, KY 42211-9632
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
614
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
614
SLP-A REGISTRATION
—
Enumeration date
05/14/2020
Last updated
05/14/2020
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