Provider Demographics
NPI:1740656784
Name:FOSTER, UNIQUE
Entity type:Individual
Prefix:
First Name:UNIQUE
Middle Name:
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 1:1920 E 2ND ST
Mailing Address - Street 2:2412
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-6352
Mailing Address - Country:US
Mailing Address - Phone:918-521-0283
Mailing Address - Fax:
Practice Address - Street 1:1920 E 2ND ST
Practice Address - Street 2:2412
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-6352
Practice Address - Country:US
Practice Address - Phone:918-521-0283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-13
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management