Individual
ALPHA FODAY FOFANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1110 WHEATFIELD CT, ROSENBERG, TX 77469-5360
(832) 341-7536
Mailing address
1110 WHEATFIELD CT, ROSENBERG, TX 77469-5360
(832) 341-7536
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
164X00000X
Licensed Vocational Nurse
Primary
217297
TX
Other
Enumeration date
06/01/2019
Last updated
07/01/2019
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