Provider Demographics
NPI:1104268895
Name:KELLY, ALLYSON VOGLER (MED, BCBA)
Entity type:Individual
Prefix:MRS
First Name:ALLYSON
Middle Name:VOGLER
Last Name:KELLY
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 WALL ST APT 1516
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10005-1949
Mailing Address - Country:US
Mailing Address - Phone:281-389-3706
Mailing Address - Fax:
Practice Address - Street 1:45 WALL ST APT 1516
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10005-1949
Practice Address - Country:US
Practice Address - Phone:281-389-3706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-23
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1-12-11682103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst