Healthcare Provider Details

I. General information

NPI: 1215948534
Provider Name (Legal Business Name): VERNA KAY FOUST L.P.C., L.B.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94 N 31ST ST
CLINTON OK
73601-9116
US

IV. Provider business mailing address

1201 SYCAMORE ST
WEATHERFORD OK
73096-2751
US

V. Phone/Fax

Practice location:
  • Phone: 580-323-6021
  • Fax: 580-323-6270
Mailing address:
  • Phone: 580-772-0286
  • Fax: 580-323-6270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1354
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0250
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: