Healthcare Provider Details

I. General information

NPI: 1316919749
Provider Name (Legal Business Name): CLAUDIA E. VOGL L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2006
Last Update Date: 01/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1753 SIDEWINDER DR
PARK CITY UT
84060-7258
US

IV. Provider business mailing address

5651 NORTH S.R. 32
PEOA UT
84061
US

V. Phone/Fax

Practice location:
  • Phone: 435-649-8347
  • Fax: 435-649-2157
Mailing address:
  • Phone: 435-783-5323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1133282-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: