Provider Demographics
NPI:1811422850
Name:MICHELLE M FORRESTER, PH.D., PC
Entity Type:Organization
Organization Name:MICHELLE M FORRESTER, PH.D., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:FORRESTER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:713-598-3559
Mailing Address - Street 1:9601 KATY FWY
Mailing Address - Street 2:SUITE 175
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:
Practice Address - Street 1:9601 KATY FWY
Practice Address - Street 2:SUITE 175
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-27
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25359103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty