Provider Demographics
NPI:1902051006
Name:FOSTER, NYLI (MA/CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:NYLI
Middle Name:
Last Name:FOSTER
Suffix:
Gender:F
Credentials:MA/CCC-SLP
Other - Prefix:MRS
Other - First Name:NYLI
Other - Middle Name:
Other - Last Name:ROSENBLATT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA/CCC-SLP
Mailing Address - Street 1:2727 W. MITCHELL STREET
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215
Mailing Address - Country:US
Mailing Address - Phone:414-383-3699
Mailing Address - Fax:414-383-3866
Practice Address - Street 1:2727 W. MITCHELL STREET
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53215
Practice Address - Country:US
Practice Address - Phone:414-383-3699
Practice Address - Fax:414-383-3866
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-18
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1912-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist