Individual
MS. ELISSA JO FORTNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1900 E MAIN ST, DANVILLE, IL 61832-5100
(217) 554-5133
Mailing address
407 W WHITE ST, #8, CHAMPAIGN, IL 61820-4842
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
IL
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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