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NPI Code Detail

MEDICARE: AMANDA MAUREEN FOSTER M.S.

MEDICARE: AMANDA MAUREEN FOSTER M.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1174731277
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA MAUREEN FOSTER M.S.
Provider Business Mailing Address
First Line : 1825 MARIKA RD
Second Line :
City : FAIRBANKS
State : AK
Zip : 99709-5521
Country : US
Telephone Number : 907-474-0890
Fax Number :
Provider Business Practice Location Address
First Line : 1423 PEGER RD
Second Line :
City : FAIRBANKS
State : AK
Zip : 99709-5169
Country : US
Telephone Number : 907-456-7010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2007
Last Update Date : 09/25/2009

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