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General NPI Number Information
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NPI Number | 1124771266
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Entity Type | Individual
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Provider Name | CHELSEY MAIRE HOGAN
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Gender | Female
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Dates
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Enumeration Date | 01/29/2022
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Last Update Date | 01/29/2022
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Provider Practice Location Address
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Address Line | 1701 N COLLINS BLVD STE 235
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City | RICHARDSON
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State | TX
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Zip | 75080-3553
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Country | US
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Telephone | 732-977-4038
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Fax |
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Provider Business Mailing Address
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Address Line | 4902 JUNIUS ST
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City | DALLAS
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State | TX
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Zip | 75214-5330
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Country | US
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Telephone | 732-977-4038
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 85417
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License Number State | TX
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