1730398066 NPI number — DR. MARY ELLEN VOEGLER-LEE PH.D.

Table of content: DR. MARY ELLEN VOEGLER-LEE PH.D. (NPI 1730398066)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730398066 NPI number — DR. MARY ELLEN VOEGLER-LEE PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VOEGLER-LEE
Provider First Name:
MARY
Provider Middle Name:
ELLEN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1730398066
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
202 WESTBROOK DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CARRBORO
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27510-2447
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-933-2765
Provider Business Mailing Address Fax Number:
919-966-7532

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
FPG CHILD DEVELOPMENT INSTITUTE
Provider Second Line Business Practice Location Address:
CB #8180
Provider Business Practice Location Address City Name:
CHAPEL HILL
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27599-8180
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-966-7167
Provider Business Practice Location Address Fax Number:
919-966-7532
Provider Enumeration Date:
05/22/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC2200X , with the licence number:  3160 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3160 . This is a "PSYCHOLOGIST LICENSE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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