Individual
SHANNON N FOSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
10668 LYDIA LN, DANVILLE, AR 72833-6890
(479) 495-9982
(479) 495-2622
Mailing address
10668 LYDIA LN, DANVILLE, AR 72833-6890
(479) 495-9982
(479) 495-2622
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR1819
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1064557
NBCOT CERT
AR
01
—
OTR1819
ARKANSAS LIC
AR
Enumeration date
07/16/2012
Last updated
07/16/2012
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