Individual provider · Type 1 NPI

Kenneth Boggie, CADC I

Addiction (Substance Use Disorder) Counselor · Coburg, OR

NPI number 1689114175 Active

Practice location

1 Serenity Lane
Coburg, OR 97408

Mailing address

PO Box 8549
Coburg, OR 97408-1313

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X161102 (OR)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1689114175

Kenneth Boggie, CADC I's National Provider Identifier is 1689114175, issued on Mar 2, 2017. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Coburg, OR. The record was last updated on Mar 2, 2017.