Individual
STACEY FOSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
716 CEMETERY RD, EDWARDS, MS 39066-9705
(601) 668-2655
Mailing address
716 CEMETERY RD, EDWARDS, MS 39066-9705
(601) 668-2655
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
12/07/2010
Last updated
05/16/2023
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