Provider Demographics
NPI:1326396730
Name:FOSTER, EUGENE HOWARD (EDD)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:HOWARD
Last Name:FOSTER
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13502 CYPRESS SPRINGS CT
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40245-7403
Mailing Address - Country:US
Mailing Address - Phone:502-241-8609
Mailing Address - Fax:
Practice Address - Street 1:13502 CYPRESS SPRINGS CT
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40245-7403
Practice Address - Country:US
Practice Address - Phone:502-241-8609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1207103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling