| Doctor Name: | JENNIFER ANN FORRISTER |
| NPI Number: | 1013107960 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ED.S, MS, LPC |
| License Number: | LPC004644 |
| Business Practice Address: | 514 West Bankhead Hwy Suite 100 Inmind Counseling & Wellness Center Villa Rica, GA - 30180 |
| Business Phone Number: | 6789413868 |
| Business Fax Number: | 6789413217 |
| Mailing Address: | 514 West Bankhead Hwy Suite 100, Inmind Counseling & Wellness Center VILLA RICA |
| State: | GA |
| Postal Code: | 30180 |
| Phone Number: | 6789413868 |
| Fax Number: | 6789413217 |
| NPI Enumeration Date: | 07/26/2007 |
| NPI Last Update Date: | 05/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LPC004644 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |