Provider Demographics
NPI:1154570380
Name:FORSBERG, ANN MACKINNON (AUD)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:MACKINNON
Last Name:FORSBERG
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MISS
Other - First Name:ANN
Other - Middle Name:LOUISE
Other - Last Name:MACKINNON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:PO BOX 10000
Mailing Address - Street 2:EXCEPTIONAL STUDENT SERVICES
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81402-9701
Mailing Address - Country:US
Mailing Address - Phone:970-249-2405
Mailing Address - Fax:970-249-4206
Practice Address - Street 1:930 COLORADO AVE
Practice Address - Street 2:AUDIOLOGY
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-4835
Practice Address - Country:US
Practice Address - Phone:970-249-2405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-11
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0403125231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist