Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 6401008266 | MI |
N | 101YS0200X | School Counselor | PF0001380 | MI |
NPI | 1225326713 |
---|---|
Provider Name | Mrs. Mary Jane Foster |
First Address | East Lansing, MI 48823-2135 |
Second Address | East Lansing, MI 48823-2135 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2011 |
Last Update Date | 18/07/2011 |