Individual
KELLY FOGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20601 N 19TH AVE APT 1023, PHOENIX, AZ 85027-3587
(888) 754-0398
Mailing address
20435 N 7TH ST APT 1023, PHOENIX, AZ 85024-6026
(815) 404-1749
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
11/17/2021
Last updated
11/17/2021
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