Lynette Fogg

NPI #1912335506 in Eagle, Idaho

Provider Information

NPI Number
1912335506
Entity Type
Individual
Name
Lynette Fogg
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Counselor - Professional
Enumeration Date
Oct 17, 2013
Last Updated
Oct 17, 2013

Practice Location

Address
1191 E IRON EAGLE DR
Address 2
SUITE 200
City
Eagle
State
Idaho
ZIP Code
83616-5148
Phone
(208) 286-2837

Specialties & Taxonomy Codes

Specialty
Counselor - ProfessionalProfessional

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