Individual
DANIEL GERARD FORTUNATO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M
Contact information
Practice address
28 WILLIAMS ST, BEVERLY, MA 01915-2324
(978) 578-2067
Mailing address
28 WILLIAMS ST, BEVERLY, MA 01915-2324
(978) 578-2067
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
302897
MA
103K00000X
Behavior Analyst
302897
MA
Other
Enumeration date
10/04/2013
Last updated
10/04/2013
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