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Individual

PROF. JENNIFER MICHELLE FOSTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, CD, IBCLC, RLC

Contact information

Practice address
213 RUSSELL CT, CANTON, GA 30115-2918
(470) 533-9119
Mailing address
213 RUSSELL CT, CANTON, GA 30115-2918
(470) 533-9119

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YM0800X
Mental Health Counselor
101YP1600X
Pastoral Counselor
103T00000X
Psychologist
133N00000X
Nutritionist
133V00000X
Registered Dietitian
171M00000X
Case Manager/Care Coordinator
172V00000X
Community Health Worker
174N00000X
Lactation Consultant (Non-RN)
Primary
332900000X
Non-Pharmacy Dispensing Site
372500000X
Chore Provider
374J00000X
Doula
374T00000X
Religious Nonmedical Nursing Personnel
376J00000X
Homemaker

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
26-3017550
1275870172
FL
01
A536433835890
FLORIDA DRIVER'S LICENSE
FL
Enumeration date
01/11/2013
Last updated
11/02/2020
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