Individual
JENNIFER RENAE WILSON-FOSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
33 ERSKINE LN, SCOTT DEPOT, WV 25560-7842
(304) 453-2800
(304) 453-2820
Mailing address
1401 CHESTNUT ST, KENOVA, WV 25530-1235
(304) 453-2800
(304) 453-2820
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810024363
—
WV
Enumeration date
10/20/2020
Last updated
10/20/2020
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