| Doctor Name: | LARESHA FOSTER |
| NPI Number: | 1134586621 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A., L.M.S.W., CAMS |
| License Number: | MSW006541 |
| Business Practice Address: | 1100 Cleveland Ave East Point, GA - 303443602 |
| Business Phone Number: | 4045647063 |
| Business Fax Number: | |
| Mailing Address: | 1100 Cleveland Ave, EAST POINT |
| State: | GA |
| Postal Code: | 303443602 |
| Phone Number: | 4045647063 |
| Fax Number: | |
| NPI Enumeration Date: | 01/28/2016 |
| NPI Last Update Date: | 03/14/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | MSW006541 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |