Healthcare Provider Details

I. General information

NPI: 1790815090
Provider Name (Legal Business Name): HELAINE ELIZABETH FOSTER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2322 ANNA JEAN CT
SANTA FE NM
87505-5275
US

IV. Provider business mailing address

2322 ANNA JEAN CT
SANTA FE NM
87505-5275
US

V. Phone/Fax

Practice location:
  • Phone: 505-820-7422
  • Fax: 505-827-1202
Mailing address:
  • Phone: 505-820-7422
  • Fax: 505-827-1202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1508
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: