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General NPI Number Information
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NPI Number | 1861472821
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Entity Type | Individual
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Provider Name | AMY A HOGEN OTR/L
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Gender | Female
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Dates
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Enumeration Date | 01/18/2006
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Last Update Date | 07/25/2013
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Provider Practice Location Address
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Address Line | 6325 JACKRABBIT LN SUITE A
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City | BELGRADE
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State | MT
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Zip | 59714-9128
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Country | US
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Telephone | 406-388-4988
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Fax |
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Provider Business Mailing Address
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Address Line | 316 N 19TH AVE
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City | BOZEMAN
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State | MT
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Zip | 59718-3120
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Country | US
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Telephone | 406-209-2047
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OT 60149318
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License Number State | WA
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