| NPI | 1194240416 |
|---|---|
| Other Name | TANYA RENAE FOGG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC CADC-14218) |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2024-12-26 |