Provider Demographics
NPI:1598448169
Name:FOSTER, ASHLEY DAWN (CIT)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:DAWN
Last Name:FOSTER
Suffix:
Gender:F
Credentials:CIT
Other - Prefix:MRS
Other - First Name:ASHLEY
Other - Middle Name:DAWN
Other - Last Name:SEPULVADO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CIT
Mailing Address - Street 1:2000 FAIRFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71104-2099
Mailing Address - Country:US
Mailing Address - Phone:318-222-8511
Mailing Address - Fax:318-222-3273
Practice Address - Street 1:505 S CAPITOL ST
Practice Address - Street 2:
Practice Address - City:MANY
Practice Address - State:LA
Practice Address - Zip Code:71449-3053
Practice Address - Country:US
Practice Address - Phone:318-222-8511
Practice Address - Fax:318-222-3273
Is Sole Proprietor?:No
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)