Individual
ELIZABETH FOGARTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
35425 W MICHIGAN AVE, WAYNE, MI 48184-9800
(602) 910-8072
Mailing address
35425 W MICHIGAN AVE, WAYNE, MI 48184-9800
(602) 910-8072
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
6802089266
MI
Other
Enumeration date
10/18/2019
Last updated
11/01/2021
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