Provider Demographics
NPI:1407815319
Name:VOGLMAIER, MARTINA M (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARTINA
Middle Name:M
Last Name:VOGLMAIER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
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Mailing Address - Street 1:22 MILL ST
Mailing Address - Street 2:SUITE 004
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-4784
Mailing Address - Country:US
Mailing Address - Phone:781-646-0500
Mailing Address - Fax:781-646-7130
Practice Address - Street 1:22 MILL ST
Practice Address - Street 2:SUITE 004
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476-4784
Practice Address - Country:US
Practice Address - Phone:781-646-0500
Practice Address - Fax:781-646-7130
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-20
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA6624103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0524697Medicaid
MA0524697Medicaid