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General NPI Number Information
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NPI Number | 1568676708
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Entity Type | Individual
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Provider Name | CANDIS JEAN HOGAN LPC, NCSP
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Gender | Female
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2000 E 15TH ST SUITE 150-C
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City | EDMOND
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State | OK
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Zip | 73013-6697
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Country | US
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Telephone | 405-819-9063
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Fax |
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Provider Business Mailing Address
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Address Line | 13672 HUMMINGBIRD DR
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City | CHOCTAW
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State | OK
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Zip | 73020-7153
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Country | US
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Telephone | 405-819-9063
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Fax | 405-285-5210
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 286
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License Number State | OK
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