Individual provider · Type 1 NPI
Jillian Louise Forman
Professional Counselor · Andover, NY
NPI number
1073169587
Active
Practice location
2 South Main St., Suite 3
Andover, NY 14806
Mailing address
67 W University St
Alfred, NY 14802-1136
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | 009608-01 (NY) |
Professional Counselor: Definition to come...
About NPI 1073169587
Jillian Louise Forman's National Provider Identifier is 1073169587, issued on Aug 12, 2019. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Andover, NY. The record was last updated on Aug 12, 2019.