Individual
MRS. AMBER LYNN FOGARTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LLPC
Contact information
Practice address
8045 MEADOWLANE DR, PORTLAND, MI 48875-1911
(517) 647-5123
Mailing address
8045 MEADOWLANE DR, PORTLAND, MI 48875-1911
(517) 647-5123
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
L1333791
MI
101YS0200X
School Counselor
L1333791
MI
Other
Enumeration date
11/14/2008
Last updated
11/14/2008
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