Individual
JESSICA FORTENBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1205 4TH ST, KEY WEST, FL 33040-3707
(305) 293-7319
Mailing address
1205 4TH ST, KEY WEST, FL 33040-3707
(305) 293-7319
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/04/2017
Last updated
04/04/2017
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