MEDICARE: MS. AIDA S. FOERSTER LLPC

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	101YM0800X	Mental Health Counselor	6401009929	MI

General Provider Information

NPI Number	:	1598831638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AIDA S. FOERSTER LLPC

Provider Business Mailing Address
First Line	:	4882 RAPID RIVER AVE SW
Second Line	:
City	:	GRANDVILLE
State	:	MI
Zip	:	49418-8805
Country	:	US
Telephone Number	:	616-485-2580
Fax Number	:

Provider Business Practice Location Address
First Line	:	1115 BALL AVE NE
Second Line	:	BUILDING C
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49505-5904
Country	:	US
Telephone Number	:	616-459-7215
Fax Number	:	616-451-0020

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

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	02/14/2012

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