Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1003095787 |
---|---|
Provider Name | Ms. Carolyn H. Forch |
First Address | Alexandria, LA 71306-9004 |
Second Address | Pineville, LA 71360-4044 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/10/2007 |
Last Update Date | 30/10/2007 |