Individual
MS. SUSAN L. FORKUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
201 S MAIN ST, BRYANT POND, ME 04219-6431
(207) 665-2616
Mailing address
PO BOX 15, 201 SOUTH MAIN STREET, BRYANT POND, ME 04219-0015
(207) 665-2616
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CC1048
ME
Other
Enumeration date
02/06/2010
Last updated
02/06/2010
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