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Individual
KEREN POMP FORTIER
Active
Individual
KEREN POMP FORTIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2110
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35756011
BCBS OF KC
KS
Enumeration date
06/04/2006
Last updated
07/02/2014
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