Individual provider · Type 1 NPI

Cassandra Boggon

Specialist · Detroit, MI

NPI number 1770803496 Active

Practice location

16203 Wyoming St
Detroit, MI 48221-3417

Call (313) 864-2788 Map

Fax (866) 267-7903

Mailing address

8457 Brace St
Detroit, MI 48228-3144

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000X2701115101 (MI)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1770803496

Cassandra Boggon's National Provider Identifier is 1770803496, issued on Jun 3, 2010. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Detroit, MI. The record was last updated on Jun 3, 2010.