Individual
DOLORES R FORTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW. CDCA
Contact information
Practice address
2532 E 86TH ST, CLEVELAND, OH 44104-2244
(216) 456-6957
Mailing address
5104 QUINCY AVE APT 2139, CLEVELAND, OH 44104-1244
(216) 235-7540
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
163220
OH
Other
Enumeration date
04/03/2019
Last updated
04/03/2019
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