Provider Demographics
NPI:1003133596
Name:FOSTER, DONNA L
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:L
Last Name:FOSTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 W LAKE RD
Mailing Address - Street 2:
Mailing Address - City:GUTHRIE
Mailing Address - State:OK
Mailing Address - Zip Code:73044-6607
Mailing Address - Country:US
Mailing Address - Phone:405-249-5356
Mailing Address - Fax:405-293-9250
Practice Address - Street 1:302 W LAKE RD
Practice Address - Street 2:
Practice Address - City:GUTHRIE
Practice Address - State:OK
Practice Address - Zip Code:73044-6607
Practice Address - Country:US
Practice Address - Phone:405-249-5356
Practice Address - Fax:405-293-9250
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-23
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst