Provider Demographics
NPI:1013215979
Name:FOSTER, AMY K (PHD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:K
Last Name:FOSTER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7517 BEECHWOOD CENTRE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-7879
Mailing Address - Country:US
Mailing Address - Phone:317-268-8070
Mailing Address - Fax:866-205-5868
Practice Address - Street 1:7517 BEECHWOOD CENTRE RD STE 300
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-7879
Practice Address - Country:US
Practice Address - Phone:317-268-8070
Practice Address - Fax:866-205-5868
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-02
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35001704A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist