Provider Demographics
NPI:1700208568
Name:VOGELSANG, TRICIA KAY
Entity Type:Individual
Prefix:MRS
First Name:TRICIA
Middle Name:KAY
Last Name:VOGELSANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8441 WAYZATA BLVD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55426
Mailing Address - Country:US
Mailing Address - Phone:763-566-0088
Mailing Address - Fax:763-566-0089
Practice Address - Street 1:8441 WAYZATA BLVD
Practice Address - Street 2:SUITE 160
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55426
Practice Address - Country:US
Practice Address - Phone:763-566-0088
Practice Address - Fax:763-566-0089
Is Sole Proprietor?:No
Enumeration Date:2014-01-14
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health