| Doctor Name: | MRS. AMY DIACHENKO FOSTER |
| NPI Number: | 1144432246 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A. |
| License Number: | 3555 |
| Business Practice Address: | 624 West Main Street Yadkinville, NC - 270557809 |
| Business Phone Number: | 3367051346 |
| Business Fax Number: | 3366776585 |
| Mailing Address: | Po Box 723, YADKINVILLE |
| State: | NC |
| Postal Code: | 270550723 |
| Phone Number: | 3367051346 |
| Fax Number: | 3366776585 |
| NPI Enumeration Date: | 05/03/2007 |
| NPI Last Update Date: | 04/13/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 3555 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |