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Individual
DR. ELI MICHAEL SIMONG FORMAN
Active
Individual
DR. ELI MICHAEL SIMONG FORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
5688633
NY
101YP2500X
Professional Counselor
0019
MD
106H00000X
Marriage & Family Therapist
Primary
37F100059900
NJ
106H00000X
Marriage & Family Therapist
M038
MD
106H00000X
Marriage & Family Therapist
MFC13681
CA
Other
Enumeration date
09/21/2006
Last updated
09/11/2025
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