Provider Demographics
NPI:1124436902
Name:FOSTER, HALLIE JACQUELINE (BCBA, LBS)
Entity type:Individual
Prefix:
First Name:HALLIE
Middle Name:JACQUELINE
Last Name:FOSTER
Suffix:
Gender:F
Credentials:BCBA, LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2326 ELDRIDGE ST APT 1
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-2306
Mailing Address - Country:US
Mailing Address - Phone:412-512-8832
Mailing Address - Fax:
Practice Address - Street 1:2326 ELDRIDGE ST APT 1
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-2306
Practice Address - Country:US
Practice Address - Phone:412-512-8832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH002310103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst