Individual
LAUREN LOYAL FOFANOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1300 S YALE ST, FLAGSTAFF, AZ 86001-6328
(713) 203-6947
Mailing address
10255 AURORA RD, FLAGSTAFF, AZ 86004-1179
(713) 203-6947
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
51007
TX
Other
Enumeration date
06/18/2010
Last updated
04/05/2025
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