Individual
TINA LARAY FOSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
686 LESTER ST, POPLAR BLUFF, MO 63901-5025
(573) 873-6833
Mailing address
686 LESTER ST, POPLAR BLUFF, MO 63901-5025
(573) 873-6833
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/03/2024
Last updated
10/03/2024
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