Individual
KELLY CHARICE FOSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
6276 JACKSON RD STE D, ANN ARBOR, MI 48103-9579
(734) 956-0051
(888) 976-6019
Mailing address
24623 CHARLES DR, BROWNSTOWN, MI 48183-5463
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401019071
MI
247200000X
Other Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912300666
—
MI
Enumeration date
10/08/2014
Last updated
03/15/2021
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