Provider Demographics
NPI:1053782979
Name:FOSTER, CLARA MARIE (MS, BCBA)
Entity type:Individual
Prefix:
First Name:CLARA
Middle Name:MARIE
Last Name:FOSTER
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8808 W 124TH ST APT 56
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-1726
Mailing Address - Country:US
Mailing Address - Phone:785-917-1306
Mailing Address - Fax:
Practice Address - Street 1:10551 BARKLEY ST STE 205
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-1812
Practice Address - Country:US
Practice Address - Phone:913-213-0676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-19
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-18-31892103K00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician