Provider Demographics
NPI:1588733174
Name:FOSTER, TAWNYA S (PSYD)
Entity type:Individual
Prefix:DR
First Name:TAWNYA
Middle Name:S
Last Name:FOSTER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 W COOKE RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3068
Mailing Address - Country:US
Mailing Address - Phone:614-947-0918
Mailing Address - Fax:614-564-9416
Practice Address - Street 1:4949 OLENTANGY RIVER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214
Practice Address - Country:US
Practice Address - Phone:614-451-6606
Practice Address - Fax:614-451-2923
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2010-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5605103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical