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NPI Code Detail

MEDICARE: LAURA LYNN FOSTER MA CCC-SLP

MEDICARE: LAURA LYNN FOSTER MA CCC-SLP
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
1235Z00000XSpeech-Language Pathologist7101003073MI

General Provider Information

NPI Number : 1497228829
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA LYNN FOSTER MA CCC-SLP
Provider Business Mailing Address
First Line : 9702 SPRINGBORN RD
Second Line :
City : CASCO
State : MI
Zip : 48064-3503
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11700 E 10 MILE RD
Second Line :
City : WARREN
State : MI
Zip : 48089-3903
Country : US
Telephone Number : 586-353-3800
Fax Number : 586-759-3552
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2019
Last Update Date : 01/08/2019

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Directions to “ LAURA LYNN FOSTER MA CCC-SLP” Practice Location

Language Start Address Practice Location
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