Provider Demographics
NPI:1588443337
Name:BOGAR, JOCELYN CORRELLE (SLPA)
Entity type:Individual
Prefix:
First Name:JOCELYN
Middle Name:CORRELLE
Last Name:BOGAR
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3250 S DOBSON RD UNIT 355
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-4923
Mailing Address - Country:US
Mailing Address - Phone:602-312-0128
Mailing Address - Fax:
Practice Address - Street 1:670 N ARIZONA AVE
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-6741
Practice Address - Country:US
Practice Address - Phone:602-790-8923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant