Individual
KAILEAH CHRISTIE-FOGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
481 GOLD STAR HWY, 301, GROTON, CT 06340-6702
(860) 287-6393
Mailing address
481 GOLD STAR HWY, 301, GROTON, CT 06340-6702
(860) 287-6393
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
8828
CT
Other
Enumeration date
12/14/2012
Last updated
08/16/2016
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