Individual
MRS. KATIE RUTH FORTUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
304 WHISPER PARK DR, WILMINGTON, NC 28411-9661
(216) 509-1327
Mailing address
304 WHISPER PARK DR, WILMINGTON, NC 28411-9661
(216) 509-1327
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12239
NC
Other
Enumeration date
04/05/2022
Last updated
04/05/2022
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