Individual
DR. STEPHANIE RAE FORNESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD, LP
Contact information
Practice address
1212 E COLLEGE DR, MARSHALL, MN 56258-2010
(507) 532-3236
(507) 532-0240
Mailing address
408 S WHITNEY ST, MARSHALL, MN 56258-1932
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
LP-4345
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043064
PREFERRED ONE
MN
01
—
136319
UCARE
MN
01
—
41552
SIOUX VALLEY HEALTH
MN
01
—
948S3FO
BLUE CROSS BLUE SHIELD
MN
01
—
HP49480
HEALTH PARTNERS
MN
Enumeration date
08/13/2006
Last updated
07/08/2007
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