Provider Demographics
NPI:1447384458
Name:FORRESTER, MICHELLE MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:MARIE
Last Name:FORRESTER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9601 KATY FWY
Mailing Address - Street 2:SUITE 380
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1342
Mailing Address - Country:US
Mailing Address - Phone:713-598-3559
Mailing Address - Fax:713-461-5889
Practice Address - Street 1:9601 KATY FWY
Practice Address - Street 2:SUITE 380
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1342
Practice Address - Country:US
Practice Address - Phone:713-598-3559
Practice Address - Fax:713-461-5889
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25359103T00000X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent