Individual
JESSICA FORTIER-LICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
4572 S HAGADORN RD, SUITE 1C, EAST LANSING, MI 48823-5385
(517) 481-2133
(517) 659-5934
Mailing address
4572 S HAGADORN RD, SUITE 1C, EAST LANSING, MI 48823-5385
(517) 481-2133
(517) 659-5934
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801084827
MI
Other
Enumeration date
11/05/2013
Last updated
11/05/2013
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