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General NPI Number Information
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NPI Number | 1730234063
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Entity Type | Individual
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Provider Name | MARSHA FOSTER WARREN LPC
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Gender | Female
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 08/14/2012
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Provider Practice Location Address
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Address Line | 13 S MULBERRY ST STE B
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City | STATESBORO
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State | GA
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Zip | 30458-7174
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Country | US
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Telephone | 912-481-2743
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Fax |
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Provider Business Mailing Address
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Address Line | 2017 PARKWAY PLACE DR
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City | STATESBORO
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State | GA
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Zip | 30458-6742
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Country | US
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Telephone | 912-481-2743
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Fax |
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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 | LPC004980
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License Number State | GA
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