Individual
MRS. AMY DIACHENKO FOSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
2554 LEWISVILLE CLEMMONS RD STE 303, CLEMMONS, NC 27012-8749
(336) 849-7890
(336) 223-5060
Mailing address
PO BOX 723, YADKINVILLE, NC 27055-0723
(336) 223-5060
(855) 726-7734
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3555
NC
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
3555
NC
103TC2200X
Clinical Child & Adolescent Psychologist
3555
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6107576
—
NC
Enumeration date
05/03/2007
Last updated
08/31/2022
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