Provider Demographics
NPI:1770076044
Name:VOGEL, SHELLEY MARIE
Entity type:Individual
Prefix:MRS
First Name:SHELLEY
Middle Name:MARIE
Last Name:VOGEL
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:SHELLEY
Other - Middle Name:MARIE
Other - Last Name:STILLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:39 SAUNDERS RD
Mailing Address - Street 2:
Mailing Address - City:GREENE
Mailing Address - State:ME
Mailing Address - Zip Code:04236-4104
Mailing Address - Country:US
Mailing Address - Phone:207-713-9918
Mailing Address - Fax:
Practice Address - Street 1:22 TUCK RD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03842-1225
Practice Address - Country:US
Practice Address - Phone:603-431-2530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-12
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant