Individual
SUSAN IVEY FORTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., CF/SLP
Contact information
Practice address
306 SHIRLEY AVE, DOUGLAS, GA 31533-2332
(912) 331-0846
(678) 792-4894
Mailing address
306 SHIRLEY AVE, DOUGLAS, GA 31533-2332
(912) 331-0846
(678) 792-4894
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
PCET002783
GA
Other
Enumeration date
10/02/2018
Last updated
10/02/2018
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