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Individual

HOLLIE FORTMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
6255 TELEGRAPH RD LOT 209, ERIE, MI 48133-9440
(971) 400-6364
Mailing address
6255 TELEGRAPH RD LOT 209, ERIE, MI 48133-9440

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S1502385
OH

Other

Enumeration date
12/07/2015
Last updated
12/07/2015
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