MEDICARE: MS. ERRICA JUNE FOSTER B.S.W.

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
1	104100000X	Social Worker		OK

General Provider Information

NPI Number	:	1134679285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ERRICA JUNE FOSTER B.S.W.

Provider Business Mailing Address
First Line	:	7741 S VICTOR AVE APT B
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74136-7720
Country	:	US
Telephone Number	:	918-402-6680
Fax Number	:

Provider Business Practice Location Address
First Line	:	7741 S VICTOR AVE APT B
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74136-7720
Country	:	US
Telephone Number	:	918-402-6680
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2016
Last Update Date	:	10/12/2016

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