Provider Demographics
NPI:1265914949
Name:FOSTER, JENNIFER ELAINE (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ELAINE
Last Name:FOSTER
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:GRUBBS
Other - Last Name:FOSTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3501 ROTTINO DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-5319
Mailing Address - Country:US
Mailing Address - Phone:972-816-3955
Mailing Address - Fax:
Practice Address - Street 1:3501 ROTTINO DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-5319
Practice Address - Country:US
Practice Address - Phone:972-816-3955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100222235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist