National Provider Identifier
Jillian Louise Forman
Jillian Louise Forman is listed in the NPPES registry with a primary specialty of Professional Counselor in Andover, NY and a listed phone number of (607) 281-8815.
Profile Overview
- NPI
- 1073169587
- Provider Type
- Individual
- Primary Specialty
- Professional Counselor
- Enumeration Date
- August 12, 2019
- Last Updated
- August 12, 2019
Practice Location
- 2 South Main St., Suite 3
- Andover, NY 14806
Phone: (607) 281-8815
Mailing Address
- 67 W University St
- Alfred, NY 14802-1136
Specialties
- Professional Counselor (101YP2500X)
Full Record
- NPI
- 1073169587
- Entity Type
- Individual
- Last Name
- Forman
- First Name
- Jillian
- Middle Name
- Louise
- Mailing Street Address
- 67 W University St
- Mailing City
- Alfred
- Mailing State
- NY
- Mailing ZIP Code
- 14802-1136
- Mailing Country
- US
- Mailing Phone
- (607) 281-8815
- Practice Street Address
- 2 South Main St., Suite 3
- Practice City
- Andover
- Practice State
- NY
- Practice ZIP Code
- 14806
- Practice Country
- US
- Practice Phone
- (607) 281-8815
- Enumeration Date
- August 12, 2019
- Last Updated
- August 12, 2019
- Sex
- Female
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Professional Counselor (101YP2500X)