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Individual

ROBYN VAN BOGART

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
320 S WALNUT ST, APPLETON, WI 54911-5918
(920) 832-5270
(920) 832-4767
Mailing address
320 S WALNUT ST, APPLETON, WI 54911-5918
(920) 832-1624

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
10671-125
WI
101YP2500X
Professional Counselor
4833-226
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100138927
WI
Enumeration date
12/01/2020
Last updated
02/26/2024
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