Kaileah Christie-fogg, Llc | |
481 Gold Star Hwy Suite 301 Groton CT 06340-6702 | |
(860) 287-6393 | |
Not Available |
Full Name | Kaileah Christie-fogg, Llc |
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Speciality | Social Worker - Clinical |
Location | 481 Gold Star Hwy, Groton, Connecticut |
Authorized Official Name and Position | Kaileah Christie-fogg (OWNER) |
Authorized Official Contact | 8602876393 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Kaileah Christie-fogg, Llc 351 Shewville Rd Ledyard CT 06339-2019 Ph: (860) 287-6393 | Kaileah Christie-fogg, Llc 481 Gold Star Hwy Suite 301 Groton CT 06340-6702 Ph: (860) 287-6393 |
NPI Number | 1780057653 |
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Provider Enumeration Date | 11/02/2015 |
Last Update Date | 10/27/2016 |
Identifier | Type | State | Issuer |
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1780057653 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 008828 (Connecticut) | Primary |
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