Individual
MARK FORSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMHC
Contact information
Practice address
1642 42ND ST NE, CEDAR RAPIDS, IA 52402-3076
(319) 377-2161
Mailing address
6704 STONYBROOK LN NE, CEDAR RAPIDS, IA 52402-5942
(319) 270-2880
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
105658
IA
Other
Enumeration date
12/04/2024
Last updated
12/04/2024
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