Individual
BRIAN A FORTIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
60MDG, 101 BODIN CIRCLE, TRAVIS AFB, CA 94535
(707) 423-5168
Mailing address
60MDG, 101 BODIN CIRCLE, TRAVIS AFB, CA 94535
(707) 423-5168
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC11711
ME
Other
Enumeration date
10/06/2006
Last updated
07/23/2019
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