Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JILLIAN LOUISE FORMAN
Active Sole ProprietorJILLIAN LOUISE FORMAN is a Professional Counselor healthcare provider located in ANDOVER, New York. NPI 1073169587 is currently active in the NPPES registry. Verify at CMS.
Professional Counselor · ANDOVER, NY
Registration Details
- NPI Number
- 1073169587
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Aug 12, 2019 (7.0375273154445 yrs)
- Last Updated
- Aug 12, 2019
- License
-
009608-01 (NY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2 SOUTH MAIN ST., SUITE 3ANDOVER, NY, 14806Browse NY providers · Browse ZIP 14806
- Phone
- 6072818815
- Primary Specialty
-
Professional Counselor
101YP2500X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.