Jere Dee Forman, LPC-SUPERVISOR

NPI #1821435330 in Allen, Texas

Provider Information

NPI Number: 1821435330
Entity Type: Individual
Name: Jere Dee Forman, LPC-SUPERVISOR
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Professional
Credential: LPC-SUPERVISOR
Enumeration Date: May 24, 2013
Last Updated: May 24, 2013

Practice Location

Address: 1333 MCDERMOTT DRIVE
Address 2: 200
City: Allen
State: Texas
ZIP Code: 75013-3089
Phone: (469) 371-5766

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X	Primary

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