Individual
ELMER SHANE FOLSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BSW
Contact information
Practice address
2 WICKERSHAM ST, MANGUM, OK 73554-9117
(580) 782-3337
Mailing address
PO BOX 386, MANGUM, OK 73554-0386
(580) 782-3337
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/05/2013
Last updated
02/05/2013
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