Provider Demographics
NPI:1225318918
Name:FOSTER, DIANNE RANDALL
Entity Type:Individual
Prefix:MS
First Name:DIANNE
Middle Name:RANDALL
Last Name:FOSTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 DIAMOND HILL RD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-6016
Mailing Address - Country:US
Mailing Address - Phone:757-838-6668
Mailing Address - Fax:
Practice Address - Street 1:57 DIAMOND HILL RD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-6016
Practice Address - Country:US
Practice Address - Phone:757-838-6668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist