Healthcare Provider Details

I. General information

NPI: 1023509486
Provider Name (Legal Business Name): CHRISTOPHER MICHAEL HOGGE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2018
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 CENTER ST
WINONA MN
55987-3595
US

IV. Provider business mailing address

14301 EWING AVE S
BURNSVILLE MN
55306-4885
US

V. Phone/Fax

Practice location:
  • Phone: 507-474-4840
  • Fax:
Mailing address:
  • Phone: 952-746-0222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License NumberLBA0286
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: