Healthcare Provider Details

I. General information

NPI: 1750947545
Provider Name (Legal Business Name): REBECCA LYN FOSTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2019
Last Update Date: 05/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

337 12TH ST APT A4
PLAINWELL MI
49080-1112
US

IV. Provider business mailing address

337 12TH ST APT A4
PLAINWELL MI
49080-1112
US

V. Phone/Fax

Practice location:
  • Phone: 269-225-2492
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: