Provider Demographics
NPI:1447514906
Name:FOLTZ, STEPHANIE J (MS)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:J
Last Name:FOLTZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MISS
Other - First Name:STEPHANIE
Other - Middle Name:J
Other - Last Name:JANES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1186
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47902-1186
Mailing Address - Country:US
Mailing Address - Phone:765-742-4848
Mailing Address - Fax:765-477-9905
Practice Address - Street 1:100 SAW MILL RD
Practice Address - Street 2:SUITE 3200
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-5592
Practice Address - Country:US
Practice Address - Phone:765-742-4848
Practice Address - Fax:765-477-9905
Is Sole Proprietor?:No
Enumeration Date:2012-06-29
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool