Healthcare Provider Details

I. General information

NPI: 1992986590
Provider Name (Legal Business Name): KATHERINE JANE BOGART M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHERINE JANE ANDERSON M.S., CCC-SLP

II. Dates (important events)

Enumeration Date: 11/26/2007
Last Update Date: 06/22/2025
Certification Date: 06/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 AUSTINE DR
BRATTLEBORO VT
05301-7223
US

IV. Provider business mailing address

138 CEDAR ST
BRATTLEBORO VT
05301-6119
US

V. Phone/Fax

Practice location:
  • Phone: 802-257-7852
  • Fax:
Mailing address:
  • Phone: 253-302-9535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSAH-2025-0079
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number144.0134537
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: