Provider Demographics
NPI:1407697782
Name:FOUST, AMANDA JEAN (LBS)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:JEAN
Last Name:FOUST
Suffix:
Gender:F
Credentials:LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1975 SWAMP RD
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-2161
Mailing Address - Country:US
Mailing Address - Phone:610-389-4592
Mailing Address - Fax:
Practice Address - Street 1:2137 SQUIRREL HILL RD
Practice Address - Street 2:
Practice Address - City:SCHWENCKSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19473
Practice Address - Country:US
Practice Address - Phone:215-527-2124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH007106106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician