Healthcare Provider Details

I. General information

NPI: 1992632962
Provider Name (Legal Business Name): BETHANY HOGSTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26208 LEE HWY
ABINGDON VA
24211-7504
US

IV. Provider business mailing address

26208 LEE HWY
ABINGDON VA
24211-7504
US

V. Phone/Fax

Practice location:
  • Phone: 276-258-5537
  • Fax: 276-477-1516
Mailing address:
  • Phone: 276-258-5537
  • Fax: 276-477-1516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: