Individual
MISS BRITTANY H BOGARDUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1002 BLACK RIVER BLVD N, ROME, NY 13440-3539
(315) 337-0773
(315) 337-2158
Mailing address
1002 BLACK RIVER BLVD N, ROME, NY 13440-3539
(315) 337-0773
(315) 337-2158
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
085831
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085831
SOCIAL WORK LICENSE
NY
Enumeration date
08/27/2014
Last updated
08/27/2014
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