Provider Demographics
NPI:1033467774
Name:FOSTER, KATHLEEN T (COTA/L, ATP)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:T
Last Name:FOSTER
Suffix:
Gender:F
Credentials:COTA/L, ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 N GROVE ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:VA
Mailing Address - Zip Code:22812-1203
Mailing Address - Country:US
Mailing Address - Phone:540-828-4047
Mailing Address - Fax:
Practice Address - Street 1:1591 PORT REPUBLIC RD
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3517
Practice Address - Country:US
Practice Address - Phone:540-437-4226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-28
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0131000343224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant