Organization
JODI FORTNER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODI LIN FORTNER LPC (LICENSED PROFESSIONAL COUNSELOR)
(636) 667-9292
Entity
Organization
Contact information
Practice address
1323 JASPER LN, WASHINGTON, MO 63090-4148
(636) 667-9292
Mailing address
1323 JASPER LN, WASHINGTON, MO 63090-4148
(636) 667-9292
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2010013715
MO
Other
Enumeration date
07/11/2013
Last updated
07/11/2013
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