MEDICARE: MS. KIM VOGEL M.ED, LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	64420	TX

General Provider Information

NPI Number	:	1386998953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KIM VOGEL M.ED, LPC

Provider Business Mailing Address
First Line	:	316 BOBWHITE DR
Second Line	:
City	:	KERRVILLE
State	:	TX
Zip	:	78028-4012
Country	:	US
Telephone Number	:	830-329-5093
Fax Number	:

Provider Business Practice Location Address
First Line	:	320 JEFFERSON ST
Second Line	:
City	:	KERRVILLE
State	:	TX
Zip	:	78028-4407
Country	:	US
Telephone Number	:	830-329-5093
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2012
Last Update Date	:	11/05/2012

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