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General NPI Number Information
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NPI Number | 1881235604
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Entity Type | Individual
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Provider Name | MICHAEL RICHARD HOGAN LMFT
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Gender | Male
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Dates
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Enumeration Date | 10/02/2019
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Last Update Date | 10/02/2019
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Provider Practice Location Address
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Address Line | 2024 W 3RD ST
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City | DULUTH
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State | MN
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Zip | 55806-2053
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Country | US
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Telephone | 218-722-1351
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Fax |
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Provider Business Mailing Address
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Address Line | 180 HIMANGO RD
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City | ESKO
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State | MN
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Zip | 55733-9431
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Country | US
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Telephone | 218-340-4462
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 939
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License Number State | MN
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