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NPI Code Detail

MEDICARE: MS. JAZELYN HOGG

MEDICARE: MS. JAZELYN HOGG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YS0200XSchool Counselor

General Provider Information

NPI Number : 1558991448
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JAZELYN HOGG
Provider Business Mailing Address
First Line : 75 E VETERANS DR APT K301
Second Line :
City : COOKEVILLE
State : TN
Zip : 38501-5145
Country : US
Telephone Number : 423-991-7866
Fax Number :
Provider Business Practice Location Address
First Line : 606 E SPRING ST STE B
Second Line :
City : COOKEVILLE
State : TN
Zip : 38501-5067
Country : US
Telephone Number : 931-303-0665
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2020
Last Update Date : 01/20/2020

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