Individual
MRS. CRISTEN MICHELLE FOGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
6100 W FRIENDLY AVE, GREENSBORO, NC 27410-4160
(336) 292-9952
Mailing address
3403 QUAKER RUN DR, GREENSBORO, NC 27410-9168
(614) 458-8420
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
7822
NC
Other
Enumeration date
05/21/2012
Last updated
05/21/2012
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