Angela Boggs
Individual provider Active NPI Developmental Therapist · Berea, KY
NPI 1114184231 · NPPES record last updated May 16, 2008
Key facts
- NPI
- 1114184231
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Developmental Therapist 222Q00000X
- License
- 200407401 (KY)
- Practice address
- Cpo 1943
Berea, KY 40404-0001 - Phone
- (859) 985-3808
- NPI assigned
- May 16, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200407401 | KY | MD | Developmental Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | 200407401 | KY | Yes |
Addresses
Primary practice location
Cpo 1943
Berea, KY 40404-0001
Mailing address
Cpo 1943
Berea, KY 40404-0001
Phone (859) 985-3808
Other providers in Berea, KY
- BHG Lviii, LLC
- BHG XXXV, LLC
- Annie Ruth Bland
- Samantha V Blandford
- Misty Blaylock
- Tonya Danielle Booth
- Ladonna Borge
- Gerri Botts
- John C Bowers
- Ariel Boyd
All providers in Berea, KY · Developmental Therapist in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 16, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.