Individual
JAY J FOSTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
130 E WALNUT ST, #706, GREEN BAY, WI 54301-4239
(920) 437-8256
(920) 437-1188
Mailing address
130 E WALNUT ST, #706, GREEN BAY, WI 54301-4239
(920) 437-8256
(920) 437-1188
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2228-057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39141300
—
WI
Enumeration date
04/23/2008
Last updated
04/23/2008
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