Individual
JESSICA FOSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CIDDT
Contact information
Practice address
41 BONHOMIE RD, HATTIESBURG, MS 39401-8648
(601) 450-0431
Mailing address
PO BOX 18679, HATTIESBURG, MS 39404-8679
(601) 705-1901
(601) 705-1952
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
0585
MS
Other
Enumeration date
09/27/2022
Last updated
09/27/2022
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