Individual
DR. VERNELL KENNEDY FOGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1107 BELLEVIEW ST, SUITE 102, COLUMBIA, SC 29201-1810
(803) 381-3171
(803) 312-9983
Mailing address
1214 ANTHONY AVE, COLUMBIA, SC 29201-1702
(803) 255-0852
(803) 312-9983
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
747
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PS0373
—
SC
Enumeration date
07/18/2005
Last updated
11/30/2012
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