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Individual

WENDY FOGG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5318 HORTON LN, ORLANDO, FL 32814-6712
(407) 252-4651
Mailing address
5318 HORTON LN, ORLANDO, FL 32814-6712

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary

Other

Enumeration date
05/06/2011
Last updated
05/06/2011
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