Provider Demographics
NPI:1720273493
Name:VOGEL, MICHELLE LYNN (MS)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:LYNN
Last Name:VOGEL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 COMPOUND LN
Mailing Address - Street 2:
Mailing Address - City:CEDAR RUN
Mailing Address - State:PA
Mailing Address - Zip Code:17727-7713
Mailing Address - Country:US
Mailing Address - Phone:570-353-2526
Mailing Address - Fax:
Practice Address - Street 1:111 WEST MICHIGAN ST
Practice Address - Street 2:PROSTEP/EXTENDICARE HEALTHSERVICES
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53203
Practice Address - Country:US
Practice Address - Phone:419-908-8781
Practice Address - Fax:414-918-2573
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL000132L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist