Healthcare Provider Details

I. General information

NPI: 1144063025
Provider Name (Legal Business Name): CLARE ELIZABETH FOREMAN CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2024
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2929 NAZARETH RD
KALAMAZOO MI
49048-2611
US

IV. Provider business mailing address

4654 WIMBLETON WAY
KALAMAZOO MI
49009-2416
US

V. Phone/Fax

Practice location:
  • Phone: 269-381-6290
  • Fax:
Mailing address:
  • Phone: 651-238-3497
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7101010064
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: