Individual
MS. ELLA R. FORTUNE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LBSW
Contact information
Practice address
2244 BROWNTOWN RD, SWCMHC/EMERALD CRCF, BISHOPVILLE, SC 29010-9664
(803) 428-6052
(803) 428-5406
Mailing address
215 N. MAGNOLIA ST., SWCMHC,, SUMTER, SC 29151-1946
(803) 775-9364
(803) 773-6615
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
3119
SC
Other
Enumeration date
05/05/2006
Last updated
07/08/2007
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