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Individual

MISS SHELLY A FOSTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, LPC

Contact information

Practice address
1520 LOGAN AVE STE 3, CHEYENNE, WY 82001-5138
(970) 817-3426
(307) 514-9445
Mailing address
1520 LOGAN AVE STE 3, CHEYENNE, WY 82001-5138
(970) 817-3426
(307) 638-8256

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
275
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
130755000
WY
01
311228
BS
WY
Enumeration date
07/12/2005
Last updated
11/25/2018
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