Individual
MS. LAURA JEAN HOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA. LLP
Contact information
Practice address
701 ESTRADA DR, BELLEVILLE, MI 48111-2994
(734) 697-5120
Mailing address
701 ESTRADA DR, BELLEVILLE, MI 48111-2994
(734) 697-5120
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301007864
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1958
AARP
MI
05
—
1958
—
MI
Enumeration date
11/25/2011
Last updated
11/25/2011
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