Individual
LORI HEATHER FOGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
1 JARRETT WHITE RD, TRIPLER AMC, HI 96859-5001
(410) 991-0486
(410) 853-3630
Mailing address
1 JARRETT WHITE RD, TRIPLER AMC, HI 96859-5001
(410) 991-0486
(410) 853-3630
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
15223
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15223
STATE OF MARYLAND DEPARTMENT OF HEALTH AND MENTAL HYGIENE
MD
Enumeration date
06/15/2011
Last updated
06/15/2011
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