Individual
JASON WAYNE FORQUER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
7219 N LITCHFIELD RD, LUKE AFB, AZ 85309-1529
(623) 856-7579
(623) 856-4433
Mailing address
7219 N LITCHFIELD RD, LUKE AFB, AZ 85309-1529
(623) 856-7579
(623) 856-4433
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-19853
AZ
Other
Enumeration date
11/21/2006
Last updated
06/21/2023
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