Individual
JENNA ANN FORAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
306 S INDEPENDENCE ST, HARRISONVILLE, MO 64701-2352
(816) 380-4010
Mailing address
306 S INDEPENDENCE ST, HARRISONVILLE, MO 64701-2352
(816) 380-4010
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2008030793
MO
101YP2500X
Professional Counselor
597
KS
Other
Enumeration date
12/17/2007
Last updated
02/13/2009
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