Provider Demographics
NPI:1790954741
Name:VOGEL, ROY KENNETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:KENNETH
Last Name:VOGEL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1606 WELLINGTON AVE
Mailing Address - Street 2:UNIT H
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7747
Mailing Address - Country:US
Mailing Address - Phone:201-362-9300
Mailing Address - Fax:910-793-6140
Practice Address - Street 1:1606 WELLINGTON AVE
Practice Address - Street 2:UNIT H
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7747
Practice Address - Country:US
Practice Address - Phone:201-362-9300
Practice Address - Fax:910-793-6140
Is Sole Proprietor?:No
Enumeration Date:2008-02-25
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC3414103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical