Provider Demographics
NPI:1053691246
Name:FORSEY, STEVEN (AUD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:FORSEY
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 N 300 W
Mailing Address - Street 2:STE 401
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-3344
Mailing Address - Country:US
Mailing Address - Phone:801-357-7499
Mailing Address - Fax:801-373-5980
Practice Address - Street 1:1055 N 300 W
Practice Address - Street 2:STE 401
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-3344
Practice Address - Country:US
Practice Address - Phone:801-357-7499
Practice Address - Fax:801-373-5980
Is Sole Proprietor?:No
Enumeration Date:2011-08-19
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8006991-4101231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist