MEDICARE: HALEY FOSTER MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1306671151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HALEY FOSTER MS

Provider Business Mailing Address
First Line	:	6301 GASTON AVE STE 800
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75214-6224
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6301 GASTON AVE STE 800
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75214-6224
Country	:	US
Telephone Number	:	214-208-7469
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/03/2024
Last Update Date	:	09/03/2024

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Directions to “ HALEY FOSTER MS” Practice Location

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