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Individual

MADELAINE MARIE FOGARTY

Active
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Individual

MADELAINE MARIE FOGARTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
91503
CA
104100000X
Social Worker
91503
CA
1041C0700X
Clinical Social Worker
Primary
125041
CA
1041C0700X
Clinical Social Worker
91503
CA
390200000X
Student in an Organized Health Care Education/Training Program
91503
CA

Other

Enumeration date
08/07/2012
Last updated
08/27/2024
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