Provider Demographics
NPI:1073498820
Name:FORBES, KATRINA
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:FORBES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 170TH AVE
Mailing Address - Street 2:
Mailing Address - City:STANWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49346-9588
Mailing Address - Country:US
Mailing Address - Phone:616-644-9127
Mailing Address - Fax:
Practice Address - Street 1:10327 GRAND RIVER RD STE 401
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-6501
Practice Address - Country:US
Practice Address - Phone:616-644-9127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician