Healthcare Provider Details

I. General information

NPI: 1679879209
Provider Name (Legal Business Name): KRISTEN LYNN OGDEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2011
Last Update Date: 01/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2908 CONCERTO CT
APEX NC
27539-3615
US

IV. Provider business mailing address

2908 CONCERTO CT
APEX NC
27539-3615
US

V. Phone/Fax

Practice location:
  • Phone: 919-363-7585
  • Fax: 919-303-3939
Mailing address:
  • Phone: 919-363-7585
  • Fax: 919-303-3939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: