| Doctor Name: | MRS. MARTHA LOUISE FOSTER-WILSON |
| NPI Number: | 1205879723 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.P.C. |
| License Number: | 16173 |
| Business Practice Address: | 515 N Cedar Ridge Dr Ste. 7e Duncanville, TX - 751163103 |
| Business Phone Number: | 9722839282 |
| Business Fax Number: | 9722839237 |
| Mailing Address: | 1220 Frenchmans Dr, DESOTO |
| State: | TX |
| Postal Code: | 751157763 |
| Phone Number: | 9722984879 |
| Fax Number: | 9722839237 |
| NPI Enumeration Date: | 06/13/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 16173 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |