Individual
MRS. REATHA RENEE FORRESTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC 1
Contact information
Practice address
1333 NW 9TH ST, PRINEVILLE, OR 97754-1482
(541) 447-2631
(541) 447-2616
Mailing address
651 NW 2ND ST, PRINEVILLE, OR 97754-1711
(541) 447-2631
(541) 447-2616
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/29/2012
Last updated
02/29/2012
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