| Doctor Name: | MS. MELISSA LINDA FOGARTY |
| NPI Number: | 1609049030 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, LMHC |
| License Number: | LH00006364 |
| Business Practice Address: | 8903 Key Peninsula Hwy N Lakebay, WA - 983499326 |
| Business Phone Number: | 2535145422 |
| Business Fax Number: | 2538842632 |
| Mailing Address: | Po Box 546, VAUGHN |
| State: | WA |
| Postal Code: | 983940546 |
| Phone Number: | 2535145422 |
| Fax Number: | 2538842632 |
| NPI Enumeration Date: | 04/07/2008 |
| NPI Last Update Date: | 01/21/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LH00006364 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |