Individual
AMY JULAINE FORAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
1001 BROADWAY STE 104, JACKSON, CA 95642-2649
(209) 256-1542
Mailing address
356 BRIERWOOD WAY, IONE, CA 95640-5207
(209) 256-1542
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
12728
CA
Other
Enumeration date
12/18/2023
Last updated
12/18/2023
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