Provider Demographics
NPI:1851648950
Name:FOSTER, JENNIFER DAWN (MS)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:DAWN
Last Name:FOSTER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13304 S ROBINSON AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-1432
Mailing Address - Country:US
Mailing Address - Phone:405-503-4460
Mailing Address - Fax:
Practice Address - Street 1:13304 S ROBINSON AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73170-1432
Practice Address - Country:US
Practice Address - Phone:405-503-4460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-07
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional