Bogue, Kirsten Lara

Bogue, Kirsten Lara is an sole proprietor health care provider with primary practice located at 1119 High Street , Bradford PA 16701. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Bogue, Kirsten Lara can be contacted via phone (716) 307-2557.

Contact Information

Primary practice address
1119 High Street Bradford PA 16701
Phone: (716) 307-2557
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 0122421 New York
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SL009962 Pennsylvania
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 012242-1 New York

Profile Details

NPI number 1548405723
LBN Legal business name Bogue, Kirsten Lara
Credentials MS CCC SLP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 2nd, 2008
Last updated Oct 19th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548405723 NPPES
New York MEDICAID 02341564

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