Healthcare Provider Details

I. General information

NPI: 1821400136
Provider Name (Legal Business Name): CHRISTY FORRISTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2014
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1721 F52 TRL
NORTH ENGLISH IA
52316-8549
US

IV. Provider business mailing address

1721 F52 TRL
NORTH ENGLISH IA
52316-8549
US

V. Phone/Fax

Practice location:
  • Phone: 319-591-1947
  • Fax:
Mailing address:
  • Phone: 319-591-1947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT106984
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: