Provider Demographics
NPI:1457017196
Name:VOGELBACH, ALLISON (AUD, CCC-A, FAAA)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:
Last Name:VOGELBACH
Suffix:
Gender:F
Credentials:AUD, CCC-A, FAAA
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:LUKOMSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD, CCC-A
Mailing Address - Street 1:4135 AMBROSIA CT APT 2022
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33916-8053
Mailing Address - Country:US
Mailing Address - Phone:239-565-7150
Mailing Address - Fax:
Practice Address - Street 1:13889 FARNESE DR
Practice Address - Street 2:
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928-5702
Practice Address - Country:US
Practice Address - Phone:239-273-2942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-16
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2350231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist