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1689114175
KENNETH BOGGIE
COBURG, OR
NPI
1689114175
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR 161102)
Enumeration Date
2017-03-02
Last Update Date
2017-03-02
Business Address
-- KENNETH BOGGIE CADC I
1 SERENITY LANE
COBURG, OR 97408
Phone number: 541-284-5695
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Mailing Address
-- KENNETH BOGGIE CADC I
PO BOX 8549
COBURG, OR 97408-1313
Phone number: 541-284-5695
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