| NPI | 1588032312 |
|---|---|
| Former Name | BRIDGETTE FOGLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: TX 56572) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 56572) |
| Enumeration Date | 2015-09-10 |
| Last Update Date | 2015-09-10 |