Individual
MATT V FORTNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1900 DAUPHIN ST, MOBILE, AL 36606-1414
(251) 222-8880
Mailing address
1900 DAUPHIN ST, MOBILE, AL 36606-1414
(251) 222-8880
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3959
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3959
AL LPC LICENSE
AL
Enumeration date
01/16/2019
Last updated
01/16/2019
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