Provider Demographics
NPI:1295106003
Name:VOGEL, SALLY (CCC/SLP)
Entity type:Individual
Prefix:
First Name:SALLY
Middle Name:
Last Name:VOGEL
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2163 COUNTY ROAD G
Mailing Address - Street 2:
Mailing Address - City:HOOPER
Mailing Address - State:NE
Mailing Address - Zip Code:68031-1259
Mailing Address - Country:US
Mailing Address - Phone:402-654-3317
Mailing Address - Fax:402-654-3699
Practice Address - Street 1:2163 COUNTY ROAD G
Practice Address - Street 2:
Practice Address - City:HOOPER
Practice Address - State:NE
Practice Address - Zip Code:68031-1259
Practice Address - Country:US
Practice Address - Phone:402-654-3317
Practice Address - Fax:402-654-3699
Is Sole Proprietor?:No
Enumeration Date:2015-10-20
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist