Provider Demographics
NPI:1083478804
Name:FORNI, ANNA (MA)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:FORNI
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 APPLEBY CT
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:46750-7969
Mailing Address - Country:US
Mailing Address - Phone:260-388-9766
Mailing Address - Fax:
Practice Address - Street 1:803 APPLEBY CT
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:IN
Practice Address - Zip Code:46750-7969
Practice Address - Country:US
Practice Address - Phone:260-388-9766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health