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General NPI Number Information
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NPI Number | 1053291237
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Entity Type | Individual
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Provider Name | TINA M VOGT
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Gender | Female
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Dates
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Enumeration Date | 09/06/2025
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Last Update Date | 09/06/2025
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Provider Practice Location Address
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Address Line | 21 FAWN MEADOW LN
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City | KILA
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State | MT
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Zip | 59920-8565
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Country | US
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Telephone | 808-755-5225
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Fax |
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Provider Business Mailing Address
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Address Line | 21 FAWN MEADOWS LN PO BOX 41
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City | KILA
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State | MT
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Zip | 59920
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Country | US
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Telephone | 808-755-5225
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number | C1159918
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License Number State | MT
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