Provider Demographics
NPI:1063510600
Name:FOGLEMAN, RUTHANN (LMHC)
Entity Type:Individual
Prefix:
First Name:RUTHANN
Middle Name:
Last Name:FOGLEMAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1614 PALM WAY
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-3926
Mailing Address - Country:US
Mailing Address - Phone:727-362-4266
Mailing Address - Fax:
Practice Address - Street 1:1614 PALM WAY
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-3926
Practice Address - Country:US
Practice Address - Phone:727-362-4266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10916101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health