Provider Demographics
NPI:1528209400
Name:FOSTER, KEISHA (CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:KEISHA
Middle Name:
Last Name:FOSTER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19119 GOLDEN HEATH LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-3819
Mailing Address - Country:US
Mailing Address - Phone:832-452-3110
Mailing Address - Fax:
Practice Address - Street 1:19119 GOLDEN HEATH LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-3819
Practice Address - Country:US
Practice Address - Phone:832-452-3110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-23
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19874235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist