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General NPI Number Information
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NPI Number | 1114219953
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Entity Type | Individual
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Provider Name | MICHAEL JOSEPH VOGEL PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 05/12/2011
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Last Update Date | 11/17/2022
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Provider Practice Location Address
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Address Line | 13036 OLD GLENN HWY
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City | EAGLE RIVER
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State | AK
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Zip | 99577-7566
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Country | US
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Telephone | 907-921-1293
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Fax | 907-416-5455
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Provider Business Mailing Address
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Address Line | 500 S COBB ST UNIT 3610
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City | PALMER
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State | AK
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Zip | 99645-1399
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Country | US
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Telephone | 907-921-1293
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Fax | 907-416-5455
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 196899
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License Number State | AK
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