Provider Demographics
NPI:1881789220
Name:FOSTER, ANGELA EDWARDS (SLP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:EDWARDS
Last Name:FOSTER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 GRETCHEN ST
Mailing Address - Street 2:
Mailing Address - City:NEW ROADS
Mailing Address - State:LA
Mailing Address - Zip Code:70760-2724
Mailing Address - Country:US
Mailing Address - Phone:225-718-2955
Mailing Address - Fax:
Practice Address - Street 1:29419 WALKER RD S
Practice Address - Street 2:
Practice Address - City:WALKER
Practice Address - State:LA
Practice Address - Zip Code:70785-7905
Practice Address - Country:US
Practice Address - Phone:225-791-7788
Practice Address - Fax:225-791-0095
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4278235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist