Individual
KELLY BENSON VOGT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
704 S KING ST, SUITE #1, LEESBURG, VA 20175-3929
(703) 771-2200
(703) 771-7080
Mailing address
704 S KING ST STE 102, LEESBURG, VA 20175-3930
(571) 233-6120
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202004338
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0154700000
—
WV
01
—
2143406
MAMSI
VA
01
—
2873-0192
CAREFIRST
VA
Enumeration date
03/05/2007
Last updated
05/07/2025
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