Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 6628 | SC |
NPI | 1003338989 |
---|---|
Provider Name | Janet Foster |
First Address | Columbia, SC 29203-9061 |
Second Address | Columbia, SC 29210-8258 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2017 |
Last Update Date | 17/03/2018 |