Provider Demographics
NPI:1215416557
Name:VOGELEY, SHANA (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SHANA
Middle Name:
Last Name:VOGELEY
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1517 LEWIS DR
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-8917
Mailing Address - Country:US
Mailing Address - Phone:254-715-8776
Mailing Address - Fax:
Practice Address - Street 1:999 RAINTREE CIR
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-4947
Practice Address - Country:US
Practice Address - Phone:972-390-8088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19261235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist