Miranda Lynn Fogg

NPI #1740704741 in Holyoke, Massachusetts

Provider Information

NPI Number: 1740704741
Entity Type: Individual
Name: Miranda Lynn Fogg
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Aug 1, 2017
Last Updated: Aug 1, 2017

Practice Location

Address: 244 WESTFIELD RD
City: Holyoke
State: Massachusetts
ZIP Code: 01040
Phone: (413) 534-3299

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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