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Individual

MS. JANE MEDLIN FORTUNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
4999 CAROLINA FOREST BLVD, SUITE 22, MYRTLE BEACH, SC 29579-3587
(843) 506-0462
(888) 727-1946
Mailing address
4999 CAROLINA FOREST BLVD, SUITE 22, MYRTLE BEACH, SC 29579-3587
(843) 506-0462
(888) 727-1946

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4937
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PC1051
SC
Enumeration date
01/03/2008
Last updated
03/27/2017
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