Individual
TAWANA BURNETT FORTUNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2107 LIBERTY ST, CHESAPEAKE, VA 23324-3527
(757) 494-7600
Mailing address
2107 LIBERTY ST, CHESAPEAKE, VA 23324-3527
(757) 494-7600
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
0813001062
VA
Other
Enumeration date
07/06/2020
Last updated
07/06/2020
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