Healthcare Provider Details

I. General information

NPI: 1861044711
Provider Name (Legal Business Name): NATALIE HOGGE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2019
Last Update Date: 07/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11725 ARBOR ST STE 210
OMAHA NE
68144-2974
US

IV. Provider business mailing address

6123 LAMPLIGHTER DR
OMAHA NE
68152-1419
US

V. Phone/Fax

Practice location:
  • Phone: 916-847-9979
  • Fax:
Mailing address:
  • Phone: 917-847-9979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: NATALIE HOGGE
Title or Position: OWNER
Credential: PLMHP
Phone: 916-847-9979