Provider Demographics
NPI:1104530971
Name:HOGGLE, JESSICA JOYE (DSW, LICSW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:JOYE
Last Name:HOGGLE
Suffix:
Gender:F
Credentials:DSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13371 COOPER BOYD RD
Mailing Address - Street 2:
Mailing Address - City:COTTONDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35453-4508
Mailing Address - Country:US
Mailing Address - Phone:205-534-4202
Mailing Address - Fax:
Practice Address - Street 1:420 28TH AVE STE 200
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-1089
Practice Address - Country:US
Practice Address - Phone:205-737-3720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-06
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3990C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL3990COtherALABAMA BOARD OF SOCIAL WORK