Fogle, Vernell Kennedy

Fogle, Vernell Kennedy is an sole proprietor health care provider with primary practice located at 1107 Belleview St Suite 102, Columbia SC 29201-1810. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Fogle, Vernell Kennedy can be contacted via phone (803) 381-3171.

Contact Information

Primary practice address
1107 Belleview St Suite 102 Columbia SC 29201-1810
Phone: (803) 381-3171
Fax: (803) 312-9983
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 747 South Carolina

Profile Details

NPI number 1063411452
LBN Legal business name Fogle, Vernell Kennedy
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 18th, 2005
Last updated Nov 30th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063411452 NPPES
South Carolina MEDICAID PS0373

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