Provider Demographics
NPI:1700134657
Name:FOSTER, NATALIE DEFAY (LAMFT, ATR)
Entity Type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:DEFAY
Last Name:FOSTER
Suffix:
Gender:F
Credentials:LAMFT, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 E NORTHERN AVE STE 215
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-3940
Mailing Address - Country:US
Mailing Address - Phone:480-360-5484
Mailing Address - Fax:
Practice Address - Street 1:1825 E NORTHERN AVE STE 215
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-3940
Practice Address - Country:US
Practice Address - Phone:480-360-5484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-27
Last Update Date:2017-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10486106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist