Provider Demographics
NPI:1386601573
Name:VOGELER-BOUTIN, DONNA CLAIRE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:CLAIRE
Last Name:VOGELER-BOUTIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:DONNA
Other - Middle Name:CLAIRE
Other - Last Name:VOGELER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:CMR 453, P. O. BOX 2194
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09074
Mailing Address - Country:US
Mailing Address - Phone:0603-181-3204
Mailing Address - Fax:0603-181-3161
Practice Address - Street 1:BUILDING 3622, RAY BARRACKS
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09074
Practice Address - Country:US
Practice Address - Phone:0603-181-3204
Practice Address - Fax:0603-181-3161
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-01
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4245-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical