Individual
MR. MARK EDWIN FORREST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.I.C.S.W.
Contact information
Practice address
330 BROOKLINE AVE, BETH ISRAEL DEACONESS MEDICAL CENTER/EAST, BOSTON, MA 02215
(617) 667-7000
(617) 667-8665
Mailing address
11 NORRIS ST, CAMBRIDGE, MA 02140-1814
(617) 354-2697
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
110768
MA
Other
Enumeration date
08/15/2006
Last updated
07/08/2007
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