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1083627335
HEIDI TARA FOGARTY
PORT HURON, MI
NPI
1083627335
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: MI 6801068838)
Enumeration Date
2006-08-15
Last Update Date
2007-07-08
Business Address
-- HEIDI TARA FOGARTY LMSW
2875 HENRY ST
PORT HURON, MI 48060-2526
Phone number: 810-987-9700
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Mailing Address
-- HEIDI TARA FOGARTY LMSW
631 SCOTT RD
KIMBALL, MI 48074-3703
Phone number: 810-367-7861
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