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Individual

MISS REBEKKAH CATHERINE FORTNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MMPP

Contact information

Practice address
12100 FIELDSTONE LN, M65, BRYANT, AR 72022-4203
(501) 351-0859
(501) 594-5200
Mailing address
12100 FIELDSTONE LN, M65, BRYANT, AR 72022-4203
(501) 351-0859
(501) 594-5200

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
10/17/2007
Last updated
10/17/2007
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