Individual
TIVICA FORTUNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPC
Contact information
Practice address
500 SOUTHLAND DR, SUITE 155-H, HOOVER, AL 35226-3710
(205) 585-5474
Mailing address
PO BOX 2282, BIRMINGHAM, AL 35201-2282
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2645
AL
Other
Enumeration date
10/16/2008
Last updated
03/11/2009
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