Individual
TAMARA LEE FOSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DT
Contact information
Practice address
25 ASA CREEK CT, SULLIVAN, IL 61951-9353
(217) 254-1956
Mailing address
25 ASA CREEK CT, SULLIVAN, IL 61951-9353
(217) 254-1956
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
TF79291208P
IL
Other
Enumeration date
01/02/2009
Last updated
01/02/2009
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