Provider Demographics
NPI:1053800631
Name:FORSYTH, KRISTEN MARGARET
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:MARGARET
Last Name:FORSYTH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7180 CLIFFWOOD CT
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48430-9308
Mailing Address - Country:US
Mailing Address - Phone:248-568-6082
Mailing Address - Fax:
Practice Address - Street 1:7180 CLIFFWOOD CT.
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MI
Practice Address - Zip Code:48430-9308
Practice Address - Country:US
Practice Address - Phone:248-568-6082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-09
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management