Individual
MISS SONYA JENELLE FOGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CONSUMER DIRECT SERV
Contact information
Practice address
1122 SELDEN AVE, NORFOLK, VA 23523-2126
(757) 579-8807
Mailing address
1122 SELDEN AVE, NORFOLK, VA 23523-2126
(757) 579-8807
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
11/12/2019
Last updated
04/25/2026
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