Provider Demographics
NPI:1720252620
Name:FOSTER, PAMELA J (MS, LPC)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:J
Last Name:FOSTER
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 W COUNTRY CLUB RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CHICKASHA
Mailing Address - State:OK
Mailing Address - Zip Code:73018-7277
Mailing Address - Country:US
Mailing Address - Phone:405-222-3018
Mailing Address - Fax:405-222-0540
Practice Address - Street 1:420 W COUNTRY CLUB RD
Practice Address - Street 2:SUITE 2
Practice Address - City:CHICKASHA
Practice Address - State:OK
Practice Address - Zip Code:73018-7277
Practice Address - Country:US
Practice Address - Phone:405-222-3018
Practice Address - Fax:405-222-0540
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3891101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health