Individual
SHAREE FORTUNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
424 GUYTON CT, MULLINS, SC 29574-6014
(843) 423-8292
(843) 423-8294
Mailing address
424 GUYTON CT, MULLINS, SC 29574-6014
(843) 423-9292
(843) 423-8294
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
251S00000X
—
SC
Enumeration date
10/13/2020
Last updated
10/13/2020
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