Individual
JERI ANN FORREST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1818 CAREW ST, SUITE 230, FORT WAYNE, IN 46805-4788
(260) 373-8000
(260) 373-8003
Mailing address
2020 RIVER RUN TRL, APT. D, FORT WAYNE, IN 46825-6080
(260) 515-4575
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34005624A
IN
Other
Enumeration date
10/21/2008
Last updated
07/28/2015
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