=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063110237
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RACHEL FOSTER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/17/2023
-----------------------------------------------------
Last Update Date | 02/17/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 505 W 15TH ST
-----------------------------------------------------
City | PLEASANTON
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66075-4095
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-352-8214
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 304 N JEFFERSON AVE
-----------------------------------------------------
City | IOLA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66749-2327
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 04048
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------