Healthcare Provider Details

I. General information

NPI: 1831243336
Provider Name (Legal Business Name): CHERIE H. OGREN MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 11/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 S 24TH ST
RICHMOND IN
47374-5805
US

IV. Provider business mailing address

208 S 24TH ST
RICHMOND IN
47374-5805
US

V. Phone/Fax

Practice location:
  • Phone: 765-914-4386
  • Fax:
Mailing address:
  • Phone: 765-914-4386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34003280A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: