Individual
BETTY L FORTUIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1000 SHORE RD, BLDG #326, CAPE ELIZABETH, ME 04107-1916
(207) 939-5270
Mailing address
860 HIGHLAND AVE, SOUTH PORTLAND, ME 04106-6831
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC14392
ME
Other
Enumeration date
08/03/2012
Last updated
04/09/2014
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