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Individual

SHERRIE NICOLE FOGG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCAS-A

Contact information

Practice address
215 BRAEBURN DR, WINSTON SALEM, NC 27127-4691
(336) 655-6946
Mailing address
215 BRAEBURN DR, WINSTON SALEM, NC 27127-4691
(336) 655-6946

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-26053
NC

Other

Enumeration date
04/02/2020
Last updated
04/02/2020
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