Provider Demographics
NPI:1760992200
Name:FOSTER, LOUQUINTIS DONNELLE AUNTE
Entity Type:Individual
Prefix:
First Name:LOUQUINTIS
Middle Name:DONNELLE AUNTE
Last Name:FOSTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7800 YOUREE DR APT 256
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-5571
Mailing Address - Country:US
Mailing Address - Phone:318-436-9157
Mailing Address - Fax:
Practice Address - Street 1:7800 YOUREE DR APT 256
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-5571
Practice Address - Country:US
Practice Address - Phone:318-436-9157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-11
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health