Organization
KAILEAH CHRISTIE-FOGG, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KAILEAH CHRISTIE-FOGG LCSW (OWNER)
(860) 287-6393
Entity
Organization
Contact information
Practice address
481 GOLD STAR HWY, SUITE 301, GROTON, CT 06340-6702
(860) 287-6393
Mailing address
351 SHEWVILLE RD, LEDYARD, CT 06339-2019
(860) 287-6393
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
008828
CT
Other
Enumeration date
11/02/2015
Last updated
10/27/2016
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