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General NPI Number Information
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NPI Number | 1245485937
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Entity Type | Individual
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Provider Name | MICHELLE LYNN HOGAN LSW
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Gender | Female
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Dates
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Enumeration Date | 11/21/2008
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Last Update Date | 11/21/2008
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Provider Practice Location Address
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Address Line | 2121 EOFF ST
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City | WHEELING
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State | WV
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Zip | 26003-3805
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Country | US
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Telephone | 304-234-3500
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Fax | 304-234-3511
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Provider Business Mailing Address
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Address Line | 250 BOGGS HILL RD
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City | WHEELING
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State | WV
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Zip | 26003-9399
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Country | US
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Telephone | 304-242-0282
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | AP00942880
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License Number State | WV
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