| Doctor Name: | REBECCA A FORNER |
| NPI Number: | 1205992559 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA CFY-SLP |
| License Number: | 8045 |
| Business Practice Address: | 9048 Peony Ln N Maple Grove, MN - 553114417 |
| Business Phone Number: | 7634169313 |
| Business Fax Number: | 7634164530 |
| Mailing Address: | 11087 Robinson Dr Nw, #232 COON RAPIDS |
| State: | MN |
| Postal Code: | 554334283 |
| Phone Number: | 6123061933 |
| Fax Number: | |
| NPI Enumeration Date: | 12/29/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 8045 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |