| Doctor Name: | JESSICA FORDE |
| NPI Number: | 1528307386 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | 0810004761 |
| Business Practice Address: | 8023 Psc Cherry Point, NC - 285338000 |
| Business Phone Number: | 2524660500 |
| Business Fax Number: | |
| Mailing Address: | 2401 Glenwood Ave, NEW BERN |
| State: | NC |
| Postal Code: | 285624307 |
| Phone Number: | 4065792361 |
| Fax Number: | |
| NPI Enumeration Date: | 02/13/2013 |
| NPI Last Update Date: | 04/08/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 0810004761 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |