Provider Demographics
NPI:1659666568
Name:FOREMAN, AMBER DAWN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:AMBER
Middle Name:DAWN
Last Name:FOREMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:MRS
Other - First Name:AMBER
Other - Middle Name:DAWN
Other - Last Name:SARRETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3900 AMERICAN DR STE 204
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-6190
Mailing Address - Country:US
Mailing Address - Phone:972-596-1543
Mailing Address - Fax:
Practice Address - Street 1:3900 AMERICAN DR STE 204
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075
Practice Address - Country:US
Practice Address - Phone:972-596-1543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-20
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34855103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical