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Individual

AUTUMN ALEXANDRIA FORTNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
211 LOSSON PUCKETT RD, GREENFIELD, TN 38230-3920
(731) 514-2358
Mailing address
211 LOSSON PUCKETT RD, GREENFIELD, TN 38230-3920
(731) 514-2358

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
02/19/2026
Last updated
02/19/2026
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