Individual
LATASHA MARIE FORTEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
7047 GERMANTOWN AVENUE, SUITE 201, PHILADELPHIA, PA 19119
(484) 430-4738
Mailing address
7047 GERMANTOWN AVE STE 201, PHILADELPHIA, PA 19119-1866
(484) 430-4738
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW021875
PA
Other
Enumeration date
11/01/2018
Last updated
05/23/2023
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