Provider Demographics
NPI:1649482373
Name:FOGARTY, KATHLEEN PATRICIA (ND)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:PATRICIA
Last Name:FOGARTY
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3741 N HASH KNIFE CIR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85749-8476
Mailing Address - Country:US
Mailing Address - Phone:206-618-2822
Mailing Address - Fax:
Practice Address - Street 1:3741 N HASH KNIFE CIR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85749-8476
Practice Address - Country:US
Practice Address - Phone:206-618-2822
Practice Address - Fax:425-883-9801
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2024-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00000570175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath