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General NPI Number Information
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NPI Number | 1013107960
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Entity Type | Individual
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Provider Name | JENNIFER ANN FORRISTER ED.S, MS, LPC
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Gender | Female
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Dates
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Enumeration Date | 07/26/2007
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Last Update Date | 01/09/2024
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Provider Practice Location Address
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Address Line | 250 10TH ST NE APT 1301
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City | ATLANTA
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State | GA
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Zip | 30309-3713
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Country | US
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Telephone | 678-785-1777
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Fax | 678-785-1777
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Provider Business Mailing Address
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Address Line | 250 10TH ST NE APT 1301
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City | ATLANTA
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State | GA
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Zip | 30309-3713
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Country | US
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Telephone | 678-785-1777
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Fax | 678-785-1777
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC004644
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License Number State | GA
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