| Doctor Name: | MS. TARA JEAN FORRESTER |
| NPI Number: | 1003186735 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS PLPC |
| License Number: | 2011036258 |
| Business Practice Address: | 6007 N 21st St Ozark, MO - 657217634 |
| Business Phone Number: | 4175816911 |
| Business Fax Number: | |
| Mailing Address: | 1002 S Crutcher Ave, SPRINGFIELD |
| State: | MO |
| Postal Code: | 658040306 |
| Phone Number: | 4178480185 |
| Fax Number: | |
| NPI Enumeration Date: | 01/11/2012 |
| NPI Last Update Date: | 01/11/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 2011036258 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |