| Kristy M Forare Psyd Llc | |
|
1109 W Euclid Ave Deland FL 32720-6553 | |
| (386) 943-9040 | |
| (386) 943-9937 |
| Full Name | Kristy M Forare Psyd Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1109 W Euclid Ave, Deland, Florida |
| Authorized Official Name and Position | Kristy Miller Forare (PRESIDENT) |
| Authorized Official Contact | 3869439040 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kristy M Forare Psyd Llc 1109 W Euclid Ave Deland FL 32720-6553 Ph: (386) 943-9040 | Kristy M Forare Psyd Llc 1109 W Euclid Ave Deland FL 32720-6553 Ph: (386) 943-9040 |
| NPI Number | 1114162070 |
|---|---|
| Provider Enumeration Date | 12/08/2008 |
| Last Update Date | 12/08/2008 |
| Medicare PECOS PAC ID | 4183781149 |
|---|---|
| Medicare Enrollment ID | O20090319000335 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114162070 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY7031 (Florida) | Primary |
| Provider Name | Kristy M Forare |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205080884 PECOS PAC ID: 8921165986 Enrollment ID: I20090319000322 |
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