Provider Demographics
NPI:1689661688
Name:FORESTER, BARBARA A (PHD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:A
Last Name:FORESTER
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 1:2906 E ORAIBI DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-8007
Mailing Address - Country:US
Mailing Address - Phone:602-494-8105
Mailing Address - Fax:602-494-8108
Practice Address - Street 1:2906 E ORAIBI DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050-8007
Practice Address - Country:US
Practice Address - Phone:480-294-8393
Practice Address - Fax:602-396-5830
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-04
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3493103TC0700X
NY014803 1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ85500Medicare ID - Type Unspecified