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Individual

DESIRAE ANN FOSTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
SUDPT

Contact information

Practice address
6005 TYEE DR SW, TUMWATER, WA 98512-7356
(360) 464-6867
Mailing address
2802 RUSSELL RD APT B103, CENTRALIA, WA 98531-1702

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
04/26/2023
Last updated
04/26/2023
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