Provider Demographics
NPI:1376961607
Name:DEFOREST, CLAUDIA (MSCC)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:
Last Name:DEFOREST
Suffix:
Gender:F
Credentials:MSCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 SHORE RD
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:RI
Mailing Address - Zip Code:02809-1325
Mailing Address - Country:US
Mailing Address - Phone:215-776-4845
Mailing Address - Fax:
Practice Address - Street 1:5 SHORE RD
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:RI
Practice Address - Zip Code:02809-1325
Practice Address - Country:US
Practice Address - Phone:215-776-4845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-03
Last Update Date:2014-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor