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NPI Code Detail

MEDICARE: COLLEEN COGLEY

MEDICARE: COLLEEN COGLEY
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1861110306
Entity Type Code : Individual
Provider Name (Legal Business Name) : COLLEEN COGLEY
Provider Business Mailing Address
First Line : 4721 S CLIFF AVE STE 103
Second Line :
City : INDEPENDENCE
State : MO
Zip : 64055-6969
Country : US
Telephone Number : 816-608-1500
Fax Number : 800-687-5070
Provider Business Practice Location Address
First Line : 14155 92 HWY
Second Line :
City : PLATTE CITY
State : MO
Zip : 64079-8907
Country : US
Telephone Number : 816-608-1500
Fax Number : 800-687-5070
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2022
Last Update Date : 08/19/2022

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Directions to “ COLLEEN COGLEY ” Practice Location

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