Individual
CAROL J FOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH D
Contact information
Practice address
W3275, WOLF RIVER ROAD, KESHENA, WI 54135
(715) 799-5451
(715) 799-5854
Mailing address
PO BOX 970, KESHENA, WI 54135-0970
(714) 799-5451
(715) 799-5854
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1945
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39127300
—
WI
Enumeration date
09/12/2005
Last updated
11/09/2007
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