Provider Demographics
NPI:1225301187
Name:FOSTER, BONITA KAY
Entity Type:Individual
Prefix:MS
First Name:BONITA
Middle Name:KAY
Last Name:FOSTER
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:BONNIE
Other - Middle Name:K
Other - Last Name:FOSTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BC-HIS
Mailing Address - Street 1:406 EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-4510
Mailing Address - Country:US
Mailing Address - Phone:719-598-1688
Mailing Address - Fax:
Practice Address - Street 1:406 EDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-4510
Practice Address - Country:US
Practice Address - Phone:719-598-1688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO85237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist