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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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