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NPI Code Detail

MEDICARE: AUDRENA FOREHAND MA

MEDICARE:   AUDRENA  FOREHAND  MA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1336713031
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUDRENA FOREHAND MA
Provider Business Mailing Address
First Line : 520 SW ATLAS DR
Second Line :
City : FORT WHITE
State : FL
Zip : 32038-2430
Country : US
Telephone Number : 352-339-5848
Fax Number :
Provider Business Practice Location Address
First Line : 1135 NW 23RD AVE STE D
Second Line :
City : GAINESVILLE
State : FL
Zip : 32609-3449
Country : US
Telephone Number : 352-339-5848
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2021
Last Update Date : 05/17/2021

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Directions to “ AUDRENA FOREHAND MA” Practice Location

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