Individual
MS. KATHLEEN MARY FORSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
QMRP
Contact information
Practice address
3355 W 440 S, VERNAL, UT 84078-8968
(435) 789-7077
(435) 789-7077
Mailing address
3355 W 440 S, VERNAL, UT 84078-8968
(435) 789-7077
(435) 789-7077
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6267566-0160
ENTITY NUMBER
UT
Enumeration date
05/15/2007
Last updated
07/08/2007
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