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General NPI Number Information
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NPI Number | 1205879723
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Entity Type | Individual
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Provider Name | MARTHA LOUISE FOSTER-WILSON L.P.C.
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Gender | Female
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 12/13/2019
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Provider Practice Location Address
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Address Line | 1220 FRENCHMANS DR
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City | DESOTO
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State | TX
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Zip | 75115-7763
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Country | US
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Telephone | 469-571-1850
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Fax | 972-780-0219
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Provider Business Mailing Address
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Address Line | 1220 FRENCHMANS DR
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City | DESOTO
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State | TX
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Zip | 75115-7763
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Country | US
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Telephone | 972-298-4879
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Fax | 972-283-9237
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 16173
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License Number State | TX
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