Basic Information
| Provider Information | |||||||||
| NPI: | 1215689468 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FORBES | ||||||||
| FirstName: | ALLISON | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | PMHNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9249 W LAKE CITY RD | ||||||||
| Address2: | |||||||||
| City: | HOUGHTON LAKE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486299602 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 9249 W LAKE CITY RD | ||||||||
| Address2: | |||||||||
| City: | HOUGHTON LAKE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486299602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9894225122 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/19/2022 | ||||||||
| LastUpdateDate: | 03/03/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | 4704324183 | MI | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.