Provider Demographics
NPI:1326242876
Name:FOSTER, KAY L (KAY FOSTER)
Entity Type:Individual
Prefix:MS
First Name:KAY
Middle Name:L
Last Name:FOSTER
Suffix:
Gender:F
Credentials:KAY FOSTER
Other - Prefix:
Other - First Name:KAY
Other - Middle Name:
Other - Last Name:FOSTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA,MHR, LPC, ATR-BC
Mailing Address - Street 1:912 SW B AVE
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73501-3956
Mailing Address - Country:US
Mailing Address - Phone:580-248-7403
Mailing Address - Fax:
Practice Address - Street 1:912 SW B AVE
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73501-3956
Practice Address - Country:US
Practice Address - Phone:580-248-7403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3084101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKHEALTHCHOICEOtherSTATE EMPLOYEES INSURANCE