Provider Demographics
NPI:1093979494
Name:ROSENBAUM VOGEL, ANDREA (PHD, MED)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:
Last Name:ROSENBAUM VOGEL
Suffix:
Gender:F
Credentials:PHD, MED
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:LYNN
Other - Last Name:ROSENBAUM VOGEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, MED
Mailing Address - Street 1:429 GAMMON PLACE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719
Mailing Address - Country:US
Mailing Address - Phone:608-274-5181
Mailing Address - Fax:608-274-2848
Practice Address - Street 1:429 GAMMON PLACE
Practice Address - Street 2:SUITE 200
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719
Practice Address - Country:US
Practice Address - Phone:608-824-7243
Practice Address - Fax:608-821-0938
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4065-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional