Provider Demographics
NPI:1154695898
Name:FOUST, CHRISTINA
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:
Last Name:FOUST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 24303
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27114-4303
Mailing Address - Country:US
Mailing Address - Phone:336-608-7034
Mailing Address - Fax:336-602-1286
Practice Address - Street 1:7025 GLENHAVEN RIDGE DR
Practice Address - Street 2:
Practice Address - City:CLEMMONS
Practice Address - State:NC
Practice Address - Zip Code:27012-8981
Practice Address - Country:US
Practice Address - Phone:336-608-7034
Practice Address - Fax:336-602-1286
Is Sole Proprietor?:No
Enumeration Date:2012-02-27
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist