Individual
COLEEN JO FORTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
136 N FRONT ST, COPLAY, PA 18037-1218
(610) 262-5995
Mailing address
331 W WABASH ST, ALLENTOWN, PA 18103-5073
(610) 504-1802
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
PN082568L
PA
Other
Enumeration date
08/12/2010
Last updated
08/12/2010
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