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Individual

BROOKE FORTENBERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
240 INDIAN RIVER RD STE C, ORANGE, CT 06477-3649
(203) 497-3867
(203) 298-0494
Mailing address
240 INDIAN RIVER RD STE C, ORANGE, CT 06477-3649
(203) 497-3867
(203) 298-0494

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11002
CT

Other

Enumeration date
04/06/2020
Last updated
04/06/2020
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