| Doctor Name: | MR. KENNETH RUSSELL FOSTER |
| NPI Number: | 1528242518 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.A./ED.S. |
| License Number: | 2650 |
| Business Practice Address: | 178 Hickory Rdg Wilkesboro, NC - 286978005 |
| Business Phone Number: | 3369841038 |
| Business Fax Number: | |
| Mailing Address: | Po Box 928, MORAVIAN FALLS |
| State: | NC |
| Postal Code: | 286540928 |
| Phone Number: | 3369841038 |
| Fax Number: | |
| NPI Enumeration Date: | 12/26/2007 |
| NPI Last Update Date: | 12/26/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 2650 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |