Doctor Name: | DANIEL FOGERTY |
NPI Number: | 1003068453 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | SLP |
License Number: | 22004493A |
Business Practice Address: | 725 N Bell Trace Cir Bloomington, IN - 474084408 |
Business Phone Number: | 8123232858 |
Business Fax Number: | |
Mailing Address: | 118 Medical Dr, CARMEL |
State: | IN |
Postal Code: | 460322923 |
Phone Number: | 3175731037 |
Fax Number: | |
NPI Enumeration Date: | 10/16/2008 |
NPI Last Update Date: | 10/16/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 22004493A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |